Stroke

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Classification

  • Intracerebral hemorrhage
  • Subarachnoid hemorrhage
  • Ischemia/infarct

Syndromes

Lacunar Syndromes

  • Pure motor: contralateral posterior limb of internal capsule or corona radiata
  • Pure sensory: contralateral ventroposterolateral thalamic nucleus
  • Mixed sensorimotor: contralateral thalamus and posterior limb of internal capsule
  • Dysarthria-clumsy hand: contralateral base of pons
  • Ataxic hemiparesis: contralateral posterior limb of internal capsule or base of pons
  • Hemiballismus/hemichorea: contralateral subthalamic nucleus

Posterior Circulation Strokes

Carotid Artery Dissection

  • Usually associated with neck pain

Vertebral Artery Dissection

Lateral Medullary Syndrome

  • Contralateral pain/temperature sensory deficit with ipsilateral Horner's syndrome, cranial nerve deficits
  • Often presents with dizziness, nausea/vomiting, nystagmus, dysphagia/dysarthria/dysphonia, Horner syndrome
  • Pain or an unpleasant feeling in the face is sometimes a prominent early feature
  • Most commonly caused by vertebral artery or PICA occlusion

Further Reading