Neurovascular Clinical Syndromes

middle cerebral artery syndrome

paresis of contralateral face, arm and leg (leg is least affected) (damage to primary motor cortex and internal capsule)

middle cerebral artery syndrome

sensory impairment over the contralateral face, arm, and leg (pain, temperature, touch, vibration, position, two-point discrimination, stereognosis) (damage to primary sensory cortex and internal capsule)

middle cerebral artery syndrome

motor speech disorder (expressive aphasia telegraphic halting speech) (damage to Broca's area in dominant hemisphere)

middle cerebral artery syndrome

Wernicke's or receptive aphasia (fluent but often jargon speech, poor comprehension) (damage to Wernicke's cortical area in dominant hemisphere)

middle cerebral artery syndrome

perceptual problems such as unilateral neglect, apraxias, depth perception problems, spatial relation difficulties (damage to parietal sensory association cortex)

middle cerebral artery syndrome

homonymous hemianopia (damaged optic radiation in internal capsule)

middle cerebral artery syndrome

loss of conjugate gaze to the opposite side (damage to the frontal eye fields or their descending tracts)

anterior cerebral artery syndrome

paresis of opposite foot and leg and to a lesser extent the arm (damage to primary motor area, medial aspect of cortex, internal capsule)

anterior cerebral artery syndrome

mental impairment (perseveration, confusion, and amnesia) (localization unknown)

anterior cerebral artery syndrome

sensory impairments primarily in lower extremity (damage to primary sensory area, medial aspect of cortex)

anterior cerebral artery syndrome

urinary incontinence (damage to posteromedial aspect of superior frontal gyrus)

anterior cerebral artery syndrome

problems with imitation and bimanual tasks, apraxia (damage to corpus callosum)

anterior cerebral artery syndrome

abulia (akinetic mutism), slowness, delay, lack of spontaneity, motor inaction (uncertain localization)

posterior cerebral artery syndrome

peripheral territory; contralateral homonymous hemianopia, prosopagnosia (difficulty naming people on sight), dyslexia (difficulty reading), without agraphia difficulty writing), color-naming (anomia), and color discrimination problems (damage to primary visual cortex or optic radiation, visual association cortex, and dominant calcarine lesion and posterior part of corpus callosum)

posterior cerebral artery syndrome

peripheral territory; memory defect (lesion of inferomedial portions of temporal lobe bilaterally or on the dominant side only)

posterior cerebral artery syndrome

peripheral territory; topographic disorientation (damage to nondominant primary visual area, usually bilaterally)

posterior cerebral artery syndrome

central territory; thalamic syndrome: sensory impairments (all modalities), spontaneous pain, and dysesthesias (damage to ventral posterolateral nucleus of thalamus)

posterior cerebral artery syndrome

central territory; involuntary movements: choreoathetosis, intention tremor, hemiballismus (damage to subthalamic nucleus or its pallidal connections)

posterior cerebral artery syndrome

central territory; contralateral hemiplegia (damage to cerebral peduncle of midbrain)

posterior cerebral artery syndrome

central territory; Weber's syndrome: oculomotor nerve palsy and contralateral hemiplegia (damage to third nerve and cerebral peduncle of midbrain)

posterior cerebral artery syndrome

paresis of vertical eye movements, slight miosis and ptosis, and sluggish pupillary light response (damage to supranuclear fibers to third nerve)

vertebrobasilar artery syndrome

vertigo, ataxia, nausea, dysarthria, dysphagia, visual (gaze) disturbances, locked-in-syndrome (damage to basilar pons, medulla, midbrain); typically will experience combination of symptoms