Cerebral Infarction



Cerebral Infarction





Specific Vessel Occlusions

See Table 39.1. Following are notes on selected features.


Middle Cerebral Artery (MCA)


Unusual Signs of Dominant Hemisphere Damage



  • Apraxia: see Chapter 2.


  • Gerstmann syndrome: agraphia, acalculia, left-right confusion, finger agnosia; infarct of angular or supramarginal gyrus.









Table 39.1 Syndromes of Cerebral Infarction





























Artery occluded Syndrome
Internal carotid Ipsilateral blindness
Contralateral hemiparesis, hemianesthesia
Hemianopia
Aphasia (dominant hemisphere),
 hemineglect (non-dominant)
Middle cerebral  
Main trunk Hemiplegia
Hemianesthesia
Hemianopia
Aphasia (dominant hemisphere),
 hemineglect (non-dominant)
Upper division Hemiparesis, sensory loss (arm, face more affected than leg)
Broca aphasia or hemineglect
Lower division Wernicke aphasia or nondominant behavior disorder without hemiparesis
Penetrating artery Pure motor hemiparesis
Anterior cerebral Hemiparesis, sensory loss (leg more affected than arm)
Impaired responsiveness (“abulia,” “akinetic mutism”), especially if bilateral infarction
Left-sided ideomotor apraxia or tactile anomia
Posterior cerebral Cortical, unilateral: isolated hemianopia, quadrantanopia; alexia or color anomia
Cortical, bilateral: cerebral blindness, with or without macular sparing
Thalamic: pure sensory stroke; may leave anesthesia dolorosa (spontaneous pain)
Subthalamic nucleus: hemiballism
Bilateral inferior temporal lobe: amnesia
Midbrain: oculomotor palsy, other eye movement abnormalities


Unusual Signs of Nondominant Hemisphere Damage

Jul 27, 2016 | Posted by in NEUROLOGY | Comments Off on Cerebral Infarction

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