MCA Syndrome Presentations
- contralateral hemiplegia face and UE > LE
- Contralateral hemisensory loss UE > LE
- Homonymous hemianopsia
- Motor speech involvement (fluence, nonfluent global aphasia or conduction aphasia - DOM hemisphere)
- Perceptual deficit (NON-DOM hemisphere)
- Loss of conjugate gaze to opposite side
- Sensory ataxia
ACA Syndrome Presentation
- Contralateral hemiplegia LE > UE
- Contralateral hemisensory loss LE > UE
- Urinary incontinence
- Problems with bimanual tasks
- Apraxia
- Decrease in verbal expression
PCA Syndrome
- Contralateral sensory loss
- Involuntary movements (choreoathetosis, tremor, hemiballismus)
- Transient contralateral hemiparesis
- Homonymous hemianopsia
- Visual agnosia
- Memory defect
- Dyslexia
- Central (thalamic) pain
- Weber’s syndome
- Oculomotor palsy
Lacunar (Pure Motor) Stroke Presentation
- Contralateral hemiplegia UE and LE
Midbrain lesion presentation
- Contralateral hemiplegia
- Contralateral CN III palsy
Medial Pontine Syndome
Paramedian branch of basilar artery
Ipsilateral to lesion:
- ataxia, nystagmus
- paralysis of conjugate gaze to side of lesion
- diplopia
Contralateral to lesion:
- Hemiparesis UE + LE
- Impaired sensation
Lateral Pontine Syndrome Presentation
Anterior inferior cerebellar artery (AICA)
Ipsilateral to lesion:
- Cerebellar: ataxia, nystagmus, vertigo
- Facial paralysis
- Paralysis of conjugate gaze to the side of lesion
- Deafness, tinnitus
- Impaired facial sensation
Contralateral to lesion:
- Impaired pain and temperature sensation half of body
Medial Medullary Syndrome Presentation
Medullary branch of Vertebral artery
Ipsilateral to lesion:
- Paralysis of half of tongue
Contralateral to lesion:
- Hemiplegia UE and LE
- Impaired sensation
Lateral Medullary (Wallenberg’s) Syndrome
Medullary branch of vertebral artery (PICA)
Ipsilateral to lesion:
- Cerebellar symptoms (ataxia, vertigo, nystagmus)
- Loss of pain and temp to face
- Sensory loss UE, trunk or LE
Contralateral to lesion
- loss of pain and temperature to body and face
- Horner’s syndrome (miosis, ptosis, anhidrosis)
- Dysphagia
- Impaired speech
