Types of Strokes
- Transient Ischemic Attack (TIA)
- Reversible Ischemic Neurologic Deficit (RIND)
- Ischemic
- Thrombotic
- Atherosclerosis
- Embolic
- Atrial Fibrillation
- Hemorrhagic
- Severe Hypertension
Middle Cerebral Artery
- Contralateral paralysis upper limb and face
- Contralateral loss of sensation of upper limb and face
- Affects Wernicke's area and Broca's area
- Aphasia if Lesion in Dominant (Left) Hemisphere
- Hemineglect if lesion in nondominant (right) hemisphere
Left Hemisphere Stroke Assessment
- Opposite Side Weakness (Hemiplegia)
- Side to Side Discrimination
- Aphasia
- Agraphia
- Slow Performance
- Aware of Deficits
- Anxiety
- Depression
Right Hemisphere Stroke Assessment
- Opposite Side Weakness (Hemiplegia)
- Poor Proprioception
- Disoriented to Person, Place, Time
- Can't Recognize Faces (Prosopagnosia)
- Loss of Judgement and Awareness
- Impulsiveness
- Personality Changes
- Tonal Hearing Loss
Anterior Cerebral Artery
- Contralateral paralysis of lower limb
- Contralateral loss of sensation in lower limb
Basilar Artery Stroke Assessment
- Brainstem Structures
- Lateral Corticospinal and Corticobulbar Tracts
- Locked-in Syndrome
- Motor Dysfunction
- Preserved Vertical Eye Movements
Anterior Inferior Cerebellar Artery Stroke Assessment
- Anterior Inferior Cerebellar Artery
- Lateral Pontine Syndrome
- Decreased Facial Pain and Temperature Sensation
- Facial Muscle Weakness
- Decreased Taste from Anterior 2/3 of Tongue
- Deceased Salivation and Lacrimation
- Nystagmus and Hearing Loss
- Horner Syndrome
- Ataxia
- Decreased Body Pain and Temperature Sensation
Histologic Evolution of Ischemic Stroke
- Irreversible Neuronal Injury
- Red Neurons
- Liquefactive Necrosis (Neutrophils)
- Microglia
- Reactive Gliosis (Astrocytes)
- Vascular Proliferation
- Glial Scar
Gerstmann Syndrome
- MCA Stroke
- Angular Gyrus
- Parietal Lobe
- Dominant Hemisphere
- Integration of Visual, Acoustic, and Sensory Information
- Left-Right Disorientation
- Finger Agnosia
- Agraphia
- Acalculia
PCA Stroke
- Contralateral Homonymous Hemianopia with Macular Sparing
- Cortical Blindness
- Thalamic Pain Syndrome
- Dorsal Midbrain Syndrome
- Contralateral Hemiparesis and Hemisensory Loss
- Dyslexia
- Alexia without Agraphia
- Aphasia
- Amnesia and Confusion
- Can't Recognize Faces (Prosopagnosia)
Wallenberg Syndrome (PICA Syndrome)
- Compromise of PICA
- Lateral Medullary Ischemia
- Vertigo
- Nystagmus
- Nausea and Vomiting
- Loss of Pain and Temperature in the Ipsilateral Face
- Loss of Pain and Temperature Sensation in the Contralateral Limbs
- Dysphagia
- Dysarthria and Dysphonia
- Loss of Gag Reflex
- Ipsilateral Horner Syndrome
- Ipsilateral Ataxia and Dysmetria, as well as Dysdiadochokinesia