NEURO

Neurology

Fact 1 of 1

Stroke Syndromes

MCA stroke = contralateral face/arm weakness + aphasia (dominant) or neglect (non-dominant). ACA = leg weakness. PCA = visual field defects.

Detailed Explanation

Middle Cerebral Artery (MCA) - Most Common:

  • Contralateral face and arm weakness > leg
  • Contralateral sensory loss (face/arm)
  • Dominant (usually left): Broca's or Wernicke's aphasia
  • Non-dominant (usually right): Hemispatial neglect
  • Gaze deviation TOWARD lesion

    • Anterior Cerebral Artery (ACA):

  • Contralateral leg weakness > arm/face
  • Personality changes (frontal lobe)
  • Urinary incontinence

    • Posterior Cerebral Artery (PCA):

  • Contralateral homonymous hemianopia
  • Memory impairment
  • Visual agnosia

    • Basilar Artery:

  • "Locked-in syndrome" - aware but cannot move
  • Cranial nerve deficits
  • Bilateral motor deficits

    • Lacunar Strokes (small vessel):

  • Pure motor hemiparesis (internal capsule)
  • Pure sensory stroke (thalamus)
  • Ataxic hemiparesis
  • Clumsy hand-dysarthria

    • Clinical Correlation

    Time is brain: tPA can be given within 4.5 hours of symptom onset (with exclusions). Mechanical thrombectomy for large vessel occlusion up to 24 hours in selected patients.

    Memory Trick

    "MCA = Middle = arms/face in the Middle of the body. ACA = A for Anterior = A for leg (Anterior walking). PCA = Posterior = back of brain = Vision."