Stroke Syndromes

Question 1

What are the 3 main symptoms assessed/looked for?

What is total anterior circulation stroke, what is partial?

Answer 1

1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
2. homonymous hemianopia
3. higher cognitive dysfunction e.g. dysphasia

TACS
- Middle and anterior cerebral arteries
- All 3 symptoms

PACS
- Small divisions of anterior circulation
- 2/3

Question 2

What is a lacunar infarct

Answer 2

Perforating arteries around internal capsule, basal ganglia, thalamus

1 of the following:
- Unilateral weakness or face and arm, arm and leg or all 3
- Pure sensory stroke
- Ataxic hemiparesis (lack of coordination and weakness on one side)

Question 3

What is a posterior circulation infarct

Answer 3

Vertebrobasilar arteries

1 of the following
- Cerebellar or brainstem syndromes
- Loss of Consciousness
- Isolated homonymous hemianopia

Question 4

What is posterior inferior cerebellar artery, what are its other names

Answer 4

AKA lateral medullary syndrome, or Wallenberg’s syndrome

Ipsilateral
- Ataxia
- Nystagmus
- Dysphagia/dysarthria
- Face pain and temp sensation loss
- Horners syndrome

Contralateral
- Loss of pain and temperature sensation in limbs

Question 5

What is Webers syndrome

Answer 5

Midbrain infarct

Ipsilateral CN III palsy (ptosis, diplopia, “down and out” eye, pupil dilated if compressive)

Contralateral spastic hemiplegia

PCA

Question 6

How do brainstem strokes present

Answer 6

Local infarction of midbrain, medulla or pons

Crossed/alternating signs
- Ipsilateral cranial nerve palsy
- Contralateral long tract signs