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
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