Ischemic stroke history and symptoms: Difference between revisions

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*Dysarthria clumsy hand syndrome  
*Dysarthria clumsy hand syndrome  
|-
|-
| 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]]
Line 102: Line 102:
*[[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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|-
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*'''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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