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Stroke Syndromes, SCRN
Name, Description, and Signs/Symptoms Related to Stroke by Involved Vessel
20
Nursing
Professional
04/17/2015

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Term
Internal Carotid Artery (ICA) Syndrome
Signs And Symptoms
Definition
* Paralysis of the contralateral face, arm and leg
* Sensory deficits of the contralateral face, arm, and leg
* Aphasia, if the dominant hemisphere is invovled
* Apraxia, agnosia, and unilateral neglect, if the nondominant hemisphere is involved
* Homonymous hemianopsia
Term
Middle Cerebral Artery (MCA) Syndrome
Description
Definition
* MCA is the most common of all cerebral occlusions
*IF the main stem of MCA is occluded, a massive infarction of most of the hemisphere results.
* Initially, there may be vomiting and a rapid onset of coma, which may last a few weeks
* Cerebral edema is extensive
Term
Middle Cerebral Artery (MCA) Syndrome
Signs And Symptoms
Definition
*Hemiplegia (involving face and arm on the contralateral side; the leg is spared or has fewer deficits than the arm)
* Sensory deficits (same area as hemiplegia)
* Aphasia (Global aphasia if the dominant hemisphere is involved)
* Homonymous hemianopsia
Term
Anterior Cerebral Artery (ACA) Syndrome Description
Definition
* ACA is least often occluded * If occlusion occurs proximal to a patent anterior communicating artery (ACom), the blood supply maybe compromised * If occlusion is distal or if the ACom artery is inadequate, there will be infarction of the medial aspect of one frontal lobe * Bilateral medial frontal lobe infarction occurs if one ACA is occluded and the other artery is small and dependent on blood flow
Term
Anterior Cerebral Artery (ACA) Syndrome
Signs And Symptoms
Definition
* Paralysis of contralateral foot and leg (foot drop is consistent finding)
* Impaired gait
* Sensory loss over toes, foot, and leg
* Abulia (slowness and prolonged delays to perform acts voluntarily or to respond)
* Flat affect, lack of spontaneity, slowness, distracibility, and lack of interest in surroundings
* Cognitive impairment, such as perseveration and amnesia
* Urinary incontinence
* Note that aphasia and hemianopsia are NOT part of the syndrome
Term
Vertebral Artery Syndrome
Description
Definition
* Occlusion of vessels within the vertebrobasilar system produces unique syndromes
* Vertebral and basilar arteries and their branches supply the brainstem and cerebellum
* Posterior cerebral arteries are the terminal branches of the basilar artery and supply the medial temporal and occipital lobes, as well as part of the corpus callosum
Term
Vertebral Artery Syndrome
Signs And Symptoms
Definition
* Wallenberg's Syndrome (lateral medullary syndrome)
* Dizziness
* Nystagmus
* Dysphagia and dysarthria
* Pain in face, nose or eye
* Ipsilateral numbness and weakness of face
* Staggering gait and ataxia
* Clumsiness
Term
Basilar Artery (BA) Syndrome
Signs and Symptoms
Definition
* Quadriplegia
*Possibly "locked-in" Syndrome
* Weakness of facial, lingual, and pharyngeal muscles
Term
Anterior Inferior Cerebellar Artery (AICA) Syndrome
Discription
Definition
Occlusion of the AICA is also known as the lateral inferior pontine syndrome
Term
Anterior Inferior Cerebellar Artery (AICA) Syndrome
Signs And Symptoms
Definition
* Vertigo
* Nausea and Vomiting
* Nystagmus
-Ipsilateral Side-
*Paresis of lateral conjugate gaze
*Horner's Syndrome
*Cerebellar signs(ataxia, nystagmus)
-Contralateral Side-
*Impaired pain and temperature sensation in trunk and limbs (may also involve face)
Term
Posterior Inferior Cerebellar Artery (PICA) Syndrome (also called Wallenberg's Syndrome)
Description
Definition
*PICA involves the lateral portion of the medulla as a results of the occlusion of the posterior inferior cerebellar artery
Term
Posterior Inferior Cerebellar Artery (PICA) Syndrome (also called Wallenberg's Syndrome)
Signs And Symptoms
Definition
* Nausea and Vomiting
* Dysphagia and dysarthria
* Horizontal nystagmus
* Ipsilateral Horner's syndrome
* Cerebllar signs (ataxia and vertigo)
* Loss of pain and temperature sensation on contralateral side of trunk and limbs
Term
Posterior Cerebral artery (PCA) Syndrome
Description
Definition
* If superficial occlusion (peripheral areas) of a PCA is involved, contralateral homonymous hemianopsia is seen
* If penetrating branches (cetnral areas) are occluded, the cerebral peduncle, thalamus and upper brainstem are involved
* There is wide variations in the manifestation of the syndrome
Term
Posterior Cerebral artery (PCA) Syndrome
Peripheral Area
Signs And Symptoms
Definition
Peripheral Area
* Homonymous hemianopsia
* Memory deficits
* Perseveration
* Several visual deficits (cortical blindness, lack of depth perception, failure to see objects not centrally located, visual hallucinations)
Term
Posterior Cerebral artery (PCA) Syndrome
Central Area
Signs And Symptoms
Definition
Central Area
*If the thalamus is involved, sensory loss of all modalities, spontaneous pain, intentional tremors, and mild hemiparesis
* If the cerebral peduncle is invovled, Weber's syndrome (oculomotor nerve palsy with contralateral hemiphlegia)
* If the brainstem is involved, deficits invovling conjugate gaze, nystagmus, and pupilary abnormalities, with other possible symptoms of ataxia and postural tremors
Term
Deep Cortical Syndromes
Description
Definition
* Four syndromes are associated with intracerebral hemorrhagic stroke
* In addition to altered LOC (Confusion to coma), headache, nausea, vomiting, nuchal rigidity, HTN, and bradycardia related to increased ICP, each syndrome has its own distinguishing characteristic
Term
Deep Cortical Syndromes
Putamen Hemorrhage (often involves internal capsule)
Signs and Symptoms
Definition
* Contralateral hemiplegia
* Contralateral hemisensory deficits
* Hemianopsia
* Slurred Speech
Term
Deep Cortical Syndromes
Thalamic Hemorrhage
Signs And Symptoms
Definition
* Contralateral hemiplegia
* Contralateral hemisensory deficits
* Deficits of veritical and lateral gaze
Term
Deep Cortical Syndromes
Pontine Hemorrhage
Signs and Symptoms
Definition
* "locked-in" syndrome
* deficits in lateral eye movement
Term
Deep Cortical Syndromes
Cerebellar Hemorrhage
Signs and Symptoms
Definition
* Occipital Headache
* Dizziness
* Ataxia
* Vertigo
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