Symptoms are characterized by...
vessel territory/location of stroke
which arteries can cause aphasia when blocked?
which arteries can cause neglect when blocked?
ICA (internal carotid artery) stroke symptoms
aphasia (dominant hemisphere), neglect (nondominant hemisphere), contralateral homonymous hemianopsia, motor and sensory loss, conjugate ipsilateral eye deviation, central retinal artery occlusion, amaurosis fugax, Horner's syndrome, miosis, facial anhidr
what is contralateral homonymous hemianopsia?
only sees one side
pertaining to the other side
pertaining to the same side
what is conjugate ipsilateral eye deviation?
stuck looking toward the area that was affected
What is amaurosis fugax?
transient monocular blindness d/t retinal ischemia (loss of blood flow to eye)
what is horner's syndrome?
ptosis, miosis, anhydrosis (particularly facial anhidrosis)
what is miosis
what is anhidrosis
inability to sweat
MCA (middle cerebral artery) stroke symptoms
aphasia (dominant), neglect (nondominant), contralateral motor/sensory loss of face, arm, and leg (leg<arm), homonymous hemaniopsia, conjugate ipsilateral eye deviation, agnosia
What is homonymous hemianopsia?
loss of half the visual field
what is agnosia?
neglect or lack of self awareness
when is agnosia usually seen?
strokes in the R hemisphere
what is abulia?
lack of concern or disinhibition
what is alexia?
inability to read
what is agraphia?
loss of ability to write or spell
what is prosopagnosia?
loss of ability to recognize faces
ACA (anterior cerebral artery) stroke symptoms
contralateral motor/sensory deficits (leg>arm) but the tongue and face are spared, abulia, possible primitive frontal reflexes like grasp and suck
which artery when blocked off affects the leg more than the arm with motor deficits?
which artery when blocked off affects the arm more than the leg with motor deficits?
Which artery when blocked causes Horner's syndrome?
PCA (posterior cerebral artery) stroke symptoms
contralateral visual field homonymous hemianopsia and visual agnosia, alexia with or without agraphia and prosopagnosia, Weber's syndrome, Parinaud's syndrome; total blindness and amnesia (when bilaterally occluded)
What symptoms characterize pure PCA strokes?
Do not include paralysis or aphasia, but sensory loss may be present
what is Weber's syndrome?
Ipsilateral CN III (occulomotor) palsy, contralateral hemiplegia, and significant bulbar dysfunction
what arterial occlusion can cause Weber's syndrome?
what is Parinaud's syndrome?
impaired up-gaze, convergence retraction nystagmus, primary conjugate downgaze
what arterial occlusion can cause Parinaud's syndrome?
PICA (posterior inferior cerebellar artery) stroke symptoms
Wallenberg's syndrome, dysphagia, dysarthia, dysphonia, ipsilateral loss of corneal reflex
What is Wallenberg's syndrome?
loss of pain and temperature sensation in the contralateral trunk and ipsilateral face
what arterial occlusion can result in wallenberg's syndrome?
what is dysphagia?
what is dysarthria?
what is dysphonia?
AICA (anterior inferior cerebellar artery) stroke symptoms
lateral pontine syndrome, ipsilateral loss of sensation to face, ipsilateral facial paralysis and hearing loss, nystagmus
what is lateral pontine syndrome?
vertigo, vomiting, nystagmus, falling toward side of lesion
what arterial occlusion can lead to lateral pontine syndrome?
what symptoms can be found in both the AICA or PICA?
dysfunction of speech, tremor, occular findings (nystagmus), abnormal gait, abnormal finger-to-nose/heel-to-shin testing
what does the finger-nose/heel-shin test indicate?
what is dysmetria?
inability to control the distance, power, and speed of a muscular action
BA (basilar artery) stroke symptoms
vertebrobasilar artery syndrome, mixed motor exam, dysconjugate gaze, and AMS with increased lethargy, Millard-Gubler syndrome; can result in locked-in syndrome and akinetic mutism
(BA=Bad Ass stroke.. and not the good kind of bad ass)
what is locked-in syndrome?
AKA akinetic mutism; Complete loss of physical movement, but totally cognitively aware; your consciousness is locked in a body that you cannot move. Pt's may be able to move their eyes in order to communicate, but gaze paresis (internuclear opthalmoplegia
what is internuclear opthalmoplegia (INO)
ocular movement disorder caused by a lesion of the medial longitudinal fasciculus. It is characterized by impaired adduction of the ipsilateral eye with nystagmus of the abducting eye
What is Millard-Gubler Syndrome?
Ventral pontine syndrome: diplopia, inability to rotate affected eye outward, ipsilateral weakness of facial muscles, and loss of corneal reflexes
Brain stem stroke symptoms
N/V, diplopia, dysarthria, dysphagia, dysconjugate gaze, gaze palsy, vertigo, tinnitus, hemiparesis/quadriplegia, sensory loss in hemibody/all four limbs, rapid decline in LOC, hiccups, abnormal respirations