Cerebrovascular Accident (CVA) Notes

Stroke vs. TIA

Stroke: Sudden loss of neurological function due to interruption of blood flow to the brain, lasting at least 24 hours. TIA (Transient Ischemic Attack): Temporary interruption of blood supply to the brain with neurologic dysfunction resolving within 24 hours, often a warning sign for future stroke.

Anterior Cerebral Circulation

Includes the anterior cerebral artery (ACA) and middle cerebral artery (MCA), originating from the internal carotid artery. Supplies the frontal, parietal, and temporal lobes.

Posterior Cerebral Circulation

Includes the vertebral and basilar arteries, supplying the brainstem, cerebellum, occipital lobe, and parts of the thalamus and temporal lobe.

ACA Syndrome Symptoms

Contralateral weakness and sensory loss primarily in the lower extremity, urinary incontinence, problems with imitation and bimanual tasks, and potential behavioral changes.

MCA Syndrome Symptoms

Contralateral sensory loss and weakness in the face and upper extremity, less involvement in the lower extremity, homonymous hemianopia, and aphasia (if the dominant hemisphere is affected).

Vertebrobasilar Syndrome Symptoms

Cranial nerve involvement (diplopia, dysphagia, dysarthria, deafness, vertigo), ataxia, and equilibrium disturbances.

Posterior Cerebral Artery (PCA) Syndrome Symptoms

Abnormal perception of pain, temperature, touch and proprioception. Contralateral sensory loss, pain, memory deficits, homonymous hemianopia, visual agnosia, and cortical blindness

Homunculus

A cortical map representing the motor and sensory distribution in the brain. Demonstrates disproportionate representation; more cortex is devoted to areas requiring fine motor control and discrimination (e.g., hands, face).

UE vs. LE Involvement (ACA)

In ACA strokes, the LE is more affected because the medial aspect of the cortex, which the ACA supplies, includes the functional area for the LE.

UE vs. LE Involvement (MCA)

In MCA strokes, the UE and face are more affected because the MCA supplies the lateral aspect of the cortex, which includes the functional areas for the UE and face.