11/13/24, 7\:34 PM Guide | Stroke classification

Stroke classi

Table of contents

Introduction

This article provides an overview of the classi

Types of stroke

Strokes can be classi
Ischaemic stroke (87%)
Haemorrhagic stroke (13%)

Ischaemic stroke

Ischaemic strokes occur when the blood supply to an area of brain tissue is reduced, resulting in tissue hypoperfusion.
There are several potential mechanisms which can result in an ischaemic stroke including\:
Embolism\: an embolus originating somewhere else in the body (e.g. the heart) causes obstruction of a cerebral vessel,
resulting in hypoperfusion to the area of the brain the vessel supplies.
Thrombosis\: a blood clot forms locally within a cerebral vessel (e.g. due to atherosclerotic plaque rupture).
Systemic hypoperfusion\: blood supply to the entire brain is reduced secondary to systemic hypotension (e.g. cardiac arrest).
Cerebral venous sinus thrombosis\: blood clots form in the veins that drain the brain, resulting in venous congestion and
tissue hypoxia.
Total anterior circulation stroke (TACS) [2]

Haemorrhagic stroke

https\://app.geekymedics.com/osce-guides/data-interpretation/stroke-classification/ 1/411/13/24, 7\:34 PM Guide | Stroke classification
Haemorrhagic strokes occur secondary to rupture of a blood vessel or abnormal vascular structure within the brain.
There are two sub-types of haemorrhagic stroke known as intracerebral haemorrhage and subarachnoid haemorrhage.
Intracerebral haemorrhage
Intracerebral haemorrhage involves bleeding within the brain secondary to a ruptured blood vessel. Intracerebral
haemorrhages can be intraparenchymal (within the brain tissue) and/or intraventricular (within the ventricles).
Subarachnoid haemorrhage
Subarachnoid haemorrhage is a type of stroke caused by bleeding outside of the brain tissue, between the pia mater and
arachnoid mater.
Intracerebral haemorrhage (intraparenchymal and intraventricular)

Blood supply of the cerebrum

The anterior, middle and posterior cerebral arteries each supply a speci
The anterior cerebral arteries supply the anteromedial area of the cerebrum.
The middle cerebral arteries supply the majority of the lateral cerebrum.
The posterior cerebral arteries supply a mixture of the medial and lateral areas of the posterior cerebrum.
https\://app.geekymedics.com/osce-guides/data-interpretation/stroke-classification/ 2/411/13/24, 7\:34 PM Guide | Stroke classification
Cerebral vascular territories [5]

Bamford classi

The most commonly used classi
Oxford classi
system does not require imaging to classify the stroke, instead, it is based on clinical

Total anterior circulation stroke (TACS)

A total anterior circulation stroke (TACS) is a large cortical stroke a
and anterior cerebral arteries.
All three of the following need to be present for a diagnosis of a TACS\:
Unilateral weakness (and/or sensory de
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)

Partial anterior circulation stroke (PACS)

A partial anterior circulation stroke (PACS) is a less severe form of TACS, in which only part of the anterior circulation has
been compromised.
Two of the following need to be present for a diagnosis of a PACS\:
Unilateral weakness (and/or sensory de
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)*
*Higher cerebral dysfunction alone is also classi

Posterior circulation syndrome (POCS)

A posterior circulation syndrome (POCS) involves damage to the area of the brain supplied by the posterior circulation (e.g.
cerebellum and brainstem).
One of the following need to be present for a diagnosis of a POCS\:
Cranial nerve palsy and a contralateral motor/sensory de
https\://app.geekymedics.com/osce-guides/data-interpretation/stroke-classification/ 3/411/13/24, 7\:34 PM Guide | Stroke classification
Bilateral motor/sensory de
Conjugate eye movement disorder (e.g. horizontal gaze palsy)
Cerebellar dysfunction (e.g. vertigo, nystagmus, ataxia)
Isolated homonymous hemianopia

Lacunar stroke (LACS)

A lacunar stroke (LACS) is a subcortical stroke that occurs secondary to small vessel disease. There is no loss of higher
cerebral functions (e.g. dysphasia).
One of the following needs to be present for a diagnosis of a LACS\:
Pure sensory stroke
Pure motor stroke
Sensori-motor stroke
Ataxic hemiparesis
Bamford stroke classi
Source\: geekymedics.com
https\://app.geekymedics.com/osce-guides/data-interpretation/stroke-classification/ 4/4