Ischemic stroke history and symptoms: Difference between revisions

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'''Deep branches''' (medial lenticulostriate, Heubner's artery)<ref name="pmid17940169">{{cite journal| author=den Heijer T, Ruitenberg A, Bakker J, Hertzberger L, Kerkhoff H| title=Neurological picture. Bilateral caudate nucleus infarction associated with variant in circle of Willis. | journal=J Neurol Neurosurg Psychiatry | year= 2007 | volume= 78 | issue= 11 | pages= 1175 | pmid=17940169 | doi=10.1136/jnnp.2006.112656 | pmc=2117617 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17940169  }} </ref><ref name="pmid2927642">{{cite journal| author=Mendez MF, Adams NL, Lewandowski KS| title=Neurobehavioral changes associated with caudate lesions. | journal=Neurology | year= 1989 | volume= 39 | issue= 3 | pages= 349-54 | pmid=2927642 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2927642  }} </ref>
'''Deep branches''' (medial lenticulostriate, Heubner's artery)<ref name="pmid17940169">{{cite journal| author=den Heijer T, Ruitenberg A, Bakker J, Hertzberger L, Kerkhoff H| title=Neurological picture. Bilateral caudate nucleus infarction associated with variant in circle of Willis. | journal=J Neurol Neurosurg Psychiatry | year= 2007 | volume= 78 | issue= 11 | pages= 1175 | pmid=17940169 | doi=10.1136/jnnp.2006.112656 | pmc=2117617 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17940169  }} </ref><ref name="pmid2927642">{{cite journal| author=Mendez MF, Adams NL, Lewandowski KS| title=Neurobehavioral changes associated with caudate lesions. | journal=Neurology | year= 1989 | volume= 39 | issue= 3 | pages= 349-54 | pmid=2927642 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2927642  }} </ref>
:*Anterior part of [[thalamus]]
:*Anterior part of [[thalamus]]
:*[[Anterior limb of internal capsule]]
:*[[Anterior limb of internal capsule]] (inferior half)
:*Head of [[caudate nucleus]]
:*Head of [[caudate nucleus]]
:*[[Putamen]]
:*[[Putamen]]
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:*Motor cortex (left head,neck and arm)
:*Motor cortex (left head,neck and arm)
:*Sensory cortex (left head, trunk and arm)
:*Sensory cortex (left head, trunk and arm)
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*Left arm and face weakness
*Contralateral left arm and face weakness
*[[Hemineglect]]
*[[Hemineglect|Contralateral Hemineglect]]
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:*[[Sensory cortex]] (right head, neck and arm)
:*[[Sensory cortex]] (right head, neck and arm)
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| style="padding: 5px 5px; background: #F5F5F5;" |
*Right arm and facial weakness  
*Contralateral right arm and facial weakness  
*[[Hemineglect]]
*Non fluent [[aphasia]] ([[Broca's aphasia]])<ref name="pmid25016386">{{cite journal| author=Fridriksson J, Fillmore P, Guo D, Rorden C| title=Chronic Broca's Aphasia Is Caused by Damage to Broca's and Wernicke's Areas. | journal=Cereb Cortex | year= 2015 | volume= 25 | issue= 12 | pages= 4689-96 | pmid=25016386 | doi=10.1093/cercor/bhu152 | pmc=4669036 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25016386  }} </ref><ref name="pmid4062622">{{cite journal| author=Henderson VW| title=Lesion localization in Broca's aphasia. Implications from Broca's aphasia without hemiparesis. | journal=Arch Neurol | year= 1985 | volume= 42 | issue= 12 | pages= 1210-2 | pmid=4062622 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4062622  }} </ref><ref name="pmid9577663">{{cite journal| author=Soma Y| title=[Cerebrovascular disorder and the language areas]. | journal=Rinsho Shinkeigaku | year= 1997 | volume= 37 | issue= 12 | pages= 1117-9 | pmid=9577663 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9577663  }} </ref>
*Non fluent [[aphasia]] ([[Broca's aphasia]])<ref name="pmid25016386">{{cite journal| author=Fridriksson J, Fillmore P, Guo D, Rorden C| title=Chronic Broca's Aphasia Is Caused by Damage to Broca's and Wernicke's Areas. | journal=Cereb Cortex | year= 2015 | volume= 25 | issue= 12 | pages= 4689-96 | pmid=25016386 | doi=10.1093/cercor/bhu152 | pmc=4669036 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25016386  }} </ref><ref name="pmid4062622">{{cite journal| author=Henderson VW| title=Lesion localization in Broca's aphasia. Implications from Broca's aphasia without hemiparesis. | journal=Arch Neurol | year= 1985 | volume= 42 | issue= 12 | pages= 1210-2 | pmid=4062622 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4062622  }} </ref><ref name="pmid9577663">{{cite journal| author=Soma Y| title=[Cerebrovascular disorder and the language areas]. | journal=Rinsho Shinkeigaku | year= 1997 | volume= 37 | issue= 12 | pages= 1117-9 | pmid=9577663 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9577663  }} </ref>
*Fluent [[aphasia]] ([[Wernicke's]] aphasia)<ref name="pmid9577663">{{cite journal| author=Soma Y| title=[Cerebrovascular disorder and the language areas]. | journal=Rinsho Shinkeigaku | year= 1997 | volume= 37 | issue= 12 | pages= 1117-9 | pmid=9577663 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9577663  }} </ref>
*Fluent [[aphasia]] ([[Wernicke's]] aphasia)<ref name="pmid9577663">{{cite journal| author=Soma Y| title=[Cerebrovascular disorder and the language areas]. | journal=Rinsho Shinkeigaku | year= 1997 | volume= 37 | issue= 12 | pages= 1117-9 | pmid=9577663 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9577663  }} </ref>
*Contralateral [[homonymous hemianopsia]]
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:*Striatum ([[Caudate nucleus|caudate]] and [[putamen]])
:*Striatum ([[Caudate nucleus|caudate]] and [[putamen]])
:*[[Globus pallidus]]
:*[[Globus pallidus]]
:*[[Internal capsule]] (anterior limb and genu)
:*[[Internal capsule]] (anterior, posterior limb and genu)
| style="padding: 5px 5px; background: #F5F5F5;" |  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Pure upper motor weakness  
*Pure upper motor weakness  

Revision as of 16:36, 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)
  • Pure upper motor weakness
Posterior cerebral artery
  • Superficial branch
  • Deep branch
  • Thalamus
  • Internal capsule (posterior limb)
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.

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