Common Stroke Syndroms

Question 1

Common stroke Syndromes

Answer 1

• Typical not universal
• Deficits produced depend on areas of the brain affected and can include sensation, speech, behavior, thought patterns and memory as well as motor deficits

Question 2

Middle Cerebral Artery Syndrome

Answer 2

• MCA

- Most common

Question 3

Typical Symptoms of MCA

Answer 3

• Contralateral upper extremity / facial weakness and sensory deficits
• Global Aphasia (if infarct is in the dominant hemisphere, usually left)
• Homonymous Hemianopia
• Loss of conjugate eye gaze

Question 4

Homonymous Hemianopia

Answer 4

• loss of the R or L half of the visual field

Question 5

Loss of conjugate eye gaze

Answer 5

• Parallel movement of the eyes

- Produces diplopia (double vision)

Question 6

Symptoms of Posterior Cerebral Artery Syndrome

Answer 6

• Contralateral Sensory Loss
• Pain
• Memory Deficits
• Homonymous hemiaopia
• Visual Agnosia
• Cortical blindness

Question 7

Visual Agnosia

Answer 7

• Inability to recognize familiar objects / people

Question 8

Cortical Blindness

Answer 8

• Acquired from occipital lobe damage

Question 9

Anterior Cerebral Artery Syndrome and Symptoms

Answer 9

• Uncommon
• Contralateral lower extremity weakness and sensory deficits
• Expressive aphasia
• Incontinence

Question 10

Vertebrobasilar Artery Syndrome and Symptoms

Answer 10

• Complete occulsion is often fatal
• Crainial nerve involvement
• Ataxia

Question 11

Crainial Nerve involvement for Vertebrobasilar Artery Syndrome

Answer 11

• Diplopia, dysarthria (difficulty controlling coordinating mm’s of speech resulting in slurred slow speech that is difficult to understand, dysphagia (difficulty swallowing) deafness, vertigo

Question 12

Ataxia

Answer 12

• lack of mm coordination during voluntary movements

Question 13

Lucunar Infarcts

Answer 13

• Usually multiple lacuna (pools) are present
• Due to occlusion of small arterioles in various locations (typically in the internal capsule)
  ie: Thalamus, basal ganglia and pons
• Can produce varied symptoms, depending on the areas involved

Question 14

Pusher Syndrome

Answer 14

• Seen with R CVA (L Hemisphere)
• Strong lateral leaning and weight shift toward the L side in all postions
  
  • opposite what is normally seen - weight shift to stronger side
• Patient strongly resists passive correction
  
  • Providing assistance with transfers is very difficult
• Increased risk of falling
  
  • Pt leans / pushes toward the involved L side, but cannot provide adequate support on that side
  • Tx should not attempt to push against the pt to correct posture (Will result in stronger push by pt)

Question 15

Typical Impairments with R CVA

Answer 15

• L Hemiplegia
• Spatial-perceptual deficits
• Impulsive, poor judgment
• Memory deficits related to performance
• Unilateral neglect
• Emotional lability

Question 16

Typical Impairments with L CVA

Answer 16

• R Hemiplegia
• Speech / Language deficits
• Apraxia
• Memory deficits related to language
• Easily frustrated, tendency to depression

Question 17

Apraxia

Answer 17

• Difficulty planning, initiating and carrying out tasks
• Slow, cautious, disorganized
• Perseveration

Question 18

Perseveration

Answer 18

• Words and gestures continuing to be repeated despite absence or sensation of a stimulus

Question 19

Thalamic Pain Syndrom

Answer 19

• Causes severe pain (burning)

- Results in stimulus perseveration (sensation lingers)

Question 20

Origin of Thalamic Pain Syndrom

Answer 20

• Lateral thalamus
• Internal capsule posterior limb
• Parietal Lobe