Ischemic stroke history and symptoms: Difference between revisions

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*Dysarthria clumsy hand syndrome  
*Dysarthria clumsy hand syndrome  
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| rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" | '''[[Posterior cerebral artery]]'''
| rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" | '''[[Posterior cerebral artery]]<ref name="pmid10773642">{{cite journal| author=Brandt T, Steinke W, Thie A, Pessin MS, Caplan LR| title=Posterior cerebral artery territory infarcts: clinical features, infarct topography, causes and outcome. Multicenter results and a review of the literature. | journal=Cerebrovasc Dis | year= 2000 | volume= 10 | issue= 3 | pages= 170-82 | pmid=10773642 | doi=16053 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10773642  }} </ref><ref name="pmid22377879">{{cite journal| author=Cereda C, Carrera E| title=Posterior cerebral artery territory infarctions. | journal=Front Neurol Neurosci | year= 2012 | volume= 30 | issue=  | pages= 128-31 | pmid=22377879 | doi=10.1159/000333610 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22377879  }} </ref><ref name="pmid10404984">{{cite journal| author=Yamamoto Y, Georgiadis AL, Chang HM, Caplan LR| title=Posterior cerebral artery territory infarcts in the New England Medical Center Posterior Circulation Registry. | journal=Arch Neurol | year= 1999 | volume= 56 | issue= 7 | pages= 824-32 | pmid=10404984 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10404984  }} </ref>'''
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*'''Cortical branches'''  
'''Cortical branches<ref name="pmid10773642">{{cite journal| author=Brandt T, Steinke W, Thie A, Pessin MS, Caplan LR| title=Posterior cerebral artery territory infarcts: clinical features, infarct topography, causes and outcome. Multicenter results and a review of the literature. | journal=Cerebrovasc Dis | year= 2000 | volume= 10 | issue= 3 | pages= 170-82 | pmid=10773642 | doi=16053 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10773642  }} </ref>''''
:*Occipital cortex
:*Occipital cortex<ref name="pmid3606035">{{cite journal| author=Pessin MS, Lathi ES, Cohen MB, Kwan ES, Hedges TR, Caplan LR| title=Clinical features and mechanism of occipital infarction. | journal=Ann Neurol | year= 1987 | volume= 21 | issue= 3 | pages= 290-9 | pmid=3606035 | doi=10.1002/ana.410210311 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3606035  }} </ref>
:*Splenium of [[corpus callosum]]
:*Splenium of [[corpus callosum]]
:*[[Hippocampus]]
:*[[Hippocampus]]
| style="padding: 5px 5px; background: #F5F5F5;" |'''Right PCA'''
| style="padding: 5px 5px; background: #F5F5F5;" |'''Right PCA<ref name="pmid3742339">{{cite journal| author=Fisher CM| title=The posterior cerebral artery syndrome. | journal=Can J Neurol Sci | year= 1986 | volume= 13 | issue= 3 | pages= 232-9 | pmid=3742339 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3742339  }} </ref>'''


*Unilateral headaches
*Unilateral headaches
*Contralateral left [[homonymous hemianopsia]]
*Contralateral left [[homonymous hemianopsia]]<ref name="pmid10773642">{{cite journal| author=Brandt T, Steinke W, Thie A, Pessin MS, Caplan LR| title=Posterior cerebral artery territory infarcts: clinical features, infarct topography, causes and outcome. Multicenter results and a review of the literature. | journal=Cerebrovasc Dis | year= 2000 | volume= 10 | issue= 3 | pages= 170-82 | pmid=10773642 | doi=16053 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10773642  }} </ref><ref name="pmid3606035">{{cite journal| author=Pessin MS, Lathi ES, Cohen MB, Kwan ES, Hedges TR, Caplan LR| title=Clinical features and mechanism of occipital infarction. | journal=Ann Neurol | year= 1987 | volume= 21 | issue= 3 | pages= 290-9 | pmid=3606035 | doi=10.1002/ana.410210311 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3606035  }} </ref>
*[[Cortical blindness]]
*[[Cortical blindness]]
*[[Visual agnosia]]
*[[Visual agnosia]]
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*[[Prosopagnosia]]
*[[Prosopagnosia]]
*[[Anomic aphasia]]
*[[Anomic aphasia]]
'''Left PCA'''
'''Left PCA<ref name="pmid3742339">{{cite journal| author=Fisher CM| title=The posterior cerebral artery syndrome. | journal=Can J Neurol Sci | year= 1986 | volume= 13 | issue= 3 | pages= 232-9 | pmid=3742339 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3742339  }} </ref><ref name="pmid10404984">{{cite journal| author=Yamamoto Y, Georgiadis AL, Chang HM, Caplan LR| title=Posterior cerebral artery territory infarcts in the New England Medical Center Posterior Circulation Registry. | journal=Arch Neurol | year= 1999 | volume= 56 | issue= 7 | pages= 824-32 | pmid=10404984 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10404984  }} </ref>'''
*[[Alexia]] without [[agraphia]]  
*[[Alexia]] without [[agraphia]]  
*[[Homonymous hemianopsia|Contralateral right homonymous hemianopsia]]
*[[Homonymous hemianopsia|Contralateral right homonymous hemianopsia]]<ref name="pmid3606035">{{cite journal| author=Pessin MS, Lathi ES, Cohen MB, Kwan ES, Hedges TR, Caplan LR| title=Clinical features and mechanism of occipital infarction. | journal=Ann Neurol | year= 1987 | volume= 21 | issue= 3 | pages= 290-9 | pmid=3606035 | doi=10.1002/ana.410210311 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3606035  }} </ref>
*[[Cortical blindness]]
*[[Cortical blindness]]
*[[Visual agnosia]]
*[[Visual agnosia]]
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|-
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*'''Ganglionic branches'''  
'''Ganglionic branches<ref name="pmid22377879">{{cite journal| author=Cereda C, Carrera E| title=Posterior cerebral artery territory infarctions. | journal=Front Neurol Neurosci | year= 2012 | volume= 30 | issue=  | pages= 128-31 | pmid=22377879 | doi=10.1159/000333610 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22377879  }} </ref>'''  
:*[[Thalamus]]  
:*[[Thalamus]] <ref name="pmid22377879">{{cite journal| author=Cereda C, Carrera E| title=Posterior cerebral artery territory infarctions. | journal=Front Neurol Neurosci | year= 2012 | volume= 30 | issue=  | pages= 128-31 | pmid=22377879 | doi=10.1159/000333610 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22377879  }} </ref>
:*[[Subthalamus]]  
:*[[Subthalamus]]  
:*[[Midbrain]]
:*[[Midbrain]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Hemisensory loss
*Hemisensory loss<ref name="pmid1640235">{{cite journal| author=Melo TP, Bogousslavsky J| title=Hemiataxia-hypesthesia: a thalamic stroke syndrome. | journal=J Neurol Neurosurg Psychiatry | year= 1992 | volume= 55 | issue= 7 | pages= 581-4 | pmid=1640235 | doi= | pmc=489170 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1640235  }} </ref>
*[[Hemiparesis|Contralateral hemiparesis]]  
*[[Hemiparesis|Contralateral hemiparesis]]<ref name="pmid1640235">{{cite journal| author=Melo TP, Bogousslavsky J| title=Hemiataxia-hypesthesia: a thalamic stroke syndrome. | journal=J Neurol Neurosurg Psychiatry | year= 1992 | volume= 55 | issue= 7 | pages= 581-4 | pmid=1640235 | doi= | pmc=489170 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1640235  }} </ref>
*Thalamic pain syndrome  
*Thalamic pain syndrome <ref name="pmid22377879">{{cite journal| author=Cereda C, Carrera E| title=Posterior cerebral artery territory infarctions. | journal=Front Neurol Neurosci | year= 2012 | volume= 30 | issue=  | pages= 128-31 | pmid=22377879 | doi=10.1159/000333610 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22377879  }} </ref>
*[[Hemiballismus]]  
*[[Hemiballismus]]  
*[[Oculomotor nerve palsy|Occulomotor nerve palsy]]  
*[[Oculomotor nerve palsy|Occulomotor nerve palsy]]  

Revision as of 18:30, 10 November 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

History and Symptoms

  • Detailed history may suggest the underlying cause for ischemic stroke. The symptoms of a stroke are related to the anatomical location of the damage; nature and severity of the symptoms can therefore vary widely
Vessel involved Site of infarction History and symptoms
Anterior cerebral artery [1][2]
  • Rare

Superficial branch

Right ACA[1][2]

Left ACA[1][3]

  • Right sided motor weakness- contralateral lower limb
  • Right sided sensory loss-contralateral lower limb
  • Transcortical motor aphasia(non fluent)[2][3]
  • Mutism
  • Contralateral grasp and sucking reflex (physical exam finding)
  • Disorganized thinking
  • Urinary incontinence
  • Behavioral abnormalities

Deep branches (medial lenticulostriate, Heubner's artery)[4][5]

Middle cerebral artery[7]
  • Most common site of infarction
  • Right superficial division (RSD)
  • Motor cortex (left head,neck and arm)
  • Sensory cortex (left head, trunk and arm)
  • Left superficial division (LSD)

Classical lacunar syndromes[13][14][15]

  • Pure motor stroke
  • Pure sensory stroke
  • Ataxic hemiparesis
  • Mixed sensorimotor stroke
  • Dysarthria clumsy hand syndrome
Posterior cerebral artery[16][17][18]

Cortical branches[16]'

Right PCA[20]

Left PCA[20][18]

Ganglionic branches[17]

Vertebrobasilar artery
  • Difficulty maintaining balance
  • Vertigo
  • Nausea
  • Vomiting
  • Tremors
  • Thalamus
  • Occipital cortex

References

  1. 1.0 1.1 1.2 Nagaratnam N, Davies D, Chen E (1998). "Clinical effects of anterior cerebral artery infarction". J Stroke Cerebrovasc Dis. 7 (6): 391–7. PMID 17895117.
  2. 2.0 2.1 2.2 2.3 Kumral E, Bayulkem G, Evyapan D, Yunten N (2002). "Spectrum of anterior cerebral artery territory infarction: clinical and MRI findings". Eur J Neurol. 9 (6): 615–24. PMID 12453077.
  3. 3.0 3.1 Alexander MP, Schmitt MA (1980). "The aphasia syndrome of stroke in the left anterior cerebral artery territory". Arch Neurol. 37 (2): 97–100. PMID 7356415.
  4. 4.0 4.1 4.2 den Heijer T, Ruitenberg A, Bakker J, Hertzberger L, Kerkhoff H (2007). "Neurological picture. Bilateral caudate nucleus infarction associated with variant in circle of Willis". J Neurol Neurosurg Psychiatry. 78 (11): 1175. doi:10.1136/jnnp.2006.112656. PMC 2117617. PMID 17940169.
  5. 5.0 5.1 Mendez MF, Adams NL, Lewandowski KS (1989). "Neurobehavioral changes associated with caudate lesions". Neurology. 39 (3): 349–54. PMID 2927642.
  6. 6.0 6.1 Mizuta H, Motomura N (2006). "Memory dysfunction in caudate infarction caused by Heubner's recurring artery occlusion". Brain Cogn. 61 (2): 133–8. doi:10.1016/j.bandc.2005.11.002. PMID 16510225.
  7. Lemieux F, Lanthier S, Chevrier MC, Gioia L, Rouleau I, Cereda C; et al. (2012). "Insular ischemic stroke: clinical presentation and outcome". Cerebrovasc Dis Extra. 2 (1): 80–7. doi:10.1159/000343177. PMC 3492997. PMID 23139684.
  8. 8.0 8.1 Fridriksson J, Fillmore P, Guo D, Rorden C (2015). "Chronic Broca's Aphasia Is Caused by Damage to Broca's and Wernicke's Areas". Cereb Cortex. 25 (12): 4689–96. doi:10.1093/cercor/bhu152. PMC 4669036. PMID 25016386.
  9. 9.0 9.1 Henderson VW (1985). "Lesion localization in Broca's aphasia. Implications from Broca's aphasia without hemiparesis". Arch Neurol. 42 (12): 1210–2. PMID 4062622.
  10. 10.0 10.1 Soma Y (1997). "[Cerebrovascular disorder and the language areas]". Rinsho Shinkeigaku. 37 (12): 1117–9. PMID 9577663.
  11. Bang OY, Heo JH, Kim JY, Park JH, Huh K (2002). "Middle cerebral artery stenosis is a major clinical determinant in striatocapsular small, deep infarction". Arch Neurol. 59 (2): 259–63. PMID 11843697.
  12. Ghika J, Bogousslavsky J, Regli F (1991). "Infarcts in the territory of lenticulostriate branches from the middle cerebral artery. Etiological factors and clinical features in 65 cases". Schweiz Arch Neurol Psychiatr (1985). 142 (1): 5–18. PMID 1709298.
  13. Arboix A, Martí-Vilalta JL (2009). "Lacunar stroke". Expert Rev Neurother. 9 (2): 179–96. doi:10.1586/14737175.9.2.179. PMID 19210194.
  14. Melo TP, Bogousslavsky J, van Melle G, Regli F (1992). "Pure motor stroke: a reappraisal". Neurology. 42 (4): 789–95. PMID 1565233.
  15. Tei H, Uchiyama S, Maruyama S (1993). "Capsular infarcts: location, size and etiology of pure motor hemiparesis, sensorimotor stroke and ataxic hemiparesis". Acta Neurol Scand. 88 (4): 264–8. PMID 8256570.
  16. 16.0 16.1 16.2 Brandt T, Steinke W, Thie A, Pessin MS, Caplan LR (2000). "Posterior cerebral artery territory infarcts: clinical features, infarct topography, causes and outcome. Multicenter results and a review of the literature". Cerebrovasc Dis. 10 (3): 170–82. doi:16053 Check |doi= value (help). PMID 10773642.
  17. 17.0 17.1 17.2 17.3 Cereda C, Carrera E (2012). "Posterior cerebral artery territory infarctions". Front Neurol Neurosci. 30: 128–31. doi:10.1159/000333610. PMID 22377879.
  18. 18.0 18.1 Yamamoto Y, Georgiadis AL, Chang HM, Caplan LR (1999). "Posterior cerebral artery territory infarcts in the New England Medical Center Posterior Circulation Registry". Arch Neurol. 56 (7): 824–32. PMID 10404984.
  19. 19.0 19.1 19.2 Pessin MS, Lathi ES, Cohen MB, Kwan ES, Hedges TR, Caplan LR (1987). "Clinical features and mechanism of occipital infarction". Ann Neurol. 21 (3): 290–9. doi:10.1002/ana.410210311. PMID 3606035.
  20. 20.0 20.1 Fisher CM (1986). "The posterior cerebral artery syndrome". Can J Neurol Sci. 13 (3): 232–9. PMID 3742339.
  21. 21.0 21.1 Melo TP, Bogousslavsky J (1992). "Hemiataxia-hypesthesia: a thalamic stroke syndrome". J Neurol Neurosurg Psychiatry. 55 (7): 581–4. PMC 489170. PMID 1640235.

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