|
Artery involved |
Syndrome |
Pathophysiology |
|
Anterior cerebral
artery |
- Motor and/or sensory deficit (foot >> face,
arm)
- Grasp, sucking reflexes
- Abulia, paratonic rigidity, gait apraxia
|
Embolic > atherothrombotic |
|
Middle cerebral artery |
- Dominant hemisphere: aphasia, motor and sensory
deficit (face, arm >leg >foot), may be complete
hemiplegia if internal capsule involved, homonymous
hemianopia.
- Non-dominant hemisphere: neglect, anosognosia, motor
and sensory deficit (face, arm > leg>foot),
homonymous hemianopia.
|
Embolic > atherothrombotic |
|
Posterior cerebral
artery |
- Homonymous hemianopia; alexia without
agraphia (dominant hemisphere); visual hallucinations,
visual perseverations (calcarine cortex); sensory loss,
choreoathetosis, spontaneous pain (thalamus); III nerve
palsy, paresis of vertical eye movement, motor deficit
(cerebral peduncle, midbrain).
|
Embolic > atherothrombotic |
|
Penetrating vessels |
- Pure motor hemiparesis (classic lacunar
syndromes)
- Pure sensory deficit
- Pure sensory-motor deficit
- Hemiparesis, homolateral ataxia
- Dysarthria/clumsy hand
|
Small artery (lacunar) infarct |
|
Vertebrobasilar |
- Cranial nerve palsies
- Crossed sensory deficits
- Diplopia, dizziness, nausea, vomiting, dysarthria,
dysphagia, hiccup
- Limp and gait ataxia
- Motory deficit
- Coma
- Bilateral signs suggest basilar artery
disease.
|
Embolic = atherothrombotic |
|
Internal carotid artery |
Progressive or stuttering onset of MCA
syndrome, occasionally ACA syndrome as well if
insufficient collateral flow. |
Atherothrombotic >
embolic |