17 Cerebral And Lacunar Strokes
Types of stroke

majority ischemic, slow onset
thrombosis: block in brain
embolism: heart emboli
hypoperfusion: cardiogenic shock

CNS Blood supply


PCA: yellow


blue: PCA
green: ACA
Pink: MCA
purple: anterior choroidal from internal carotid/MCA, posterior limb of internal capsule
MCA


arm affected more than leg, face also affected

upper portion has dual innervation from both sides of cortex


ACA


PCA



left visual fields of both eyes cross and processed by right posterior lobe


deep branches of PCA supply thalamus
Hypoxic Encephalopathy


Watershed Area


can move hands/feet but not thighs/shoulders
Lacunar Stroke

Locations


internal capsule: hemiparesis
thalamus: sensory loss to one side of body
most commonly lenticulostriate arteries from MCA (red): IC and basal ganglia


microatheroma: mo in vessel walls and build up of plaques
Symptoms

last 2 types rare
ataxic hemiparesis: ataxia much more than weakness. Dysarthria from cerebellar problem

Case

most likely motor or sensory
important: maybe negative initial CT
Last updated
Was this helpful?