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Stroke by anatomy

Site of the lesion Associated effects
Anterior cerebral artery Contralateral hemiparesis and sensory loss, lower extremity > upper
Middle cerebral artery Contralateral hemiparesis and sensory loss, upper extremity > lower Contralateral homonymous hemianopia Aphasia
Posterior cerebral artery Contralateral homonymous hemianopia with macular sparing Visual agnosia
Weber's syndrome (branches of the posterior cerebral artery that supply the midbrain) Ipsilateral CN III palsy Contralateral weakness of upper and lower extremity
Posterior inferior cerebellar artery (lateral medullary syndrome, Wallenberg syndrome) Ipsilateral: facial pain and temperature loss Contralateral: limb/torso pain and temperature loss Ataxia, nystagmus
Anterior inferior cerebellar artery (lateral pontine syndrome) Symptoms are similar to Wallenberg's (see above), but: Ipsilateral: facial paralysis and deafness
Retinal/ophthalmic artery Amaurosis fugax
Basilar artery 'Locked-in' syndrome

Lacunar strokes

  • present with either isolated hemiparesis, hemisensory loss or hemiparesis with limb ataxia
  • strong association with hypertension
  • common sites include the basal ganglia, thalamus and internal capsule