Effects of strokes

Stroke effects vary based on the specific artery involved. Here’s a structured guide to the arterial territories, common lesion areas, symptoms, and keynotes about each stroke type.

Table of Stroke Effects by Artery

Artery	Area of Lesion	Symptoms	Notes
Anterior Circulation
Middle Cerebral Artery (MCA)	– Motor and sensory cortices (upper limb and face) – Temporal lobe (Wernicke area); Frontal lobe (Broca area)	– Contralateral paralysis and sensory loss (face and upper limb) – Aphasia (if dominant hemisphere) – Hemineglect (if nondominant hemisphere)	Wernicke aphasia associated with right superior quadrant visual field defect
Anterior Cerebral Artery (ACA)	Motor and sensory cortices (lower limb)	– Contralateral paralysis and sensory loss (lower limb) – Urinary incontinence
Lenticulostriate Artery	Striatum, internal capsule	– Contralateral paralysis – Absence of cortical signs (e.g., neglect, aphasia, visual field loss)	Pure motor stroke; common site for lacunar infarcts due to unmanaged hypertension
Posterior Circulation
Anterior Spinal Artery (ASA)	– Corticospinal tract – Medial lemniscus – Caudal medulla (hypoglossal nerve)	– Contralateral paralysis (upper and lower limbs) – Loss of contralateral proprioception – Ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally)	Medial medullary syndrome due to ASA or vertebral artery infarcts
Posterior Inferior Cerebellar Artery (PICA)	– Lateral medulla (nucleus ambiguus – CN IX, X, XI; vestibular nuclei) – Lateral spinothalamic tract – Spinal trigeminal nucleus – Sympathetic fibers – Inferior cerebellar peduncle	– Dysphagia, hoarseness, reduced gag reflex, hiccups – Vertigo, nystagmus – Contralateral pain/temp loss (body), ipsilateral face – Ipsilateral Horner syndrome – Ataxia, dysmetria	Lateral medullary (Wallenberg) syndrome Nucleus ambiguus effects specific to PICA lesions (“Don’t pick a (PICA) horse that can’t eat”)
Anterior Inferior Cerebellar Artery (AICA)	– Lateral pons (facial nucleus, vestibular nuclei, spinothalamic tract) – Sympathetic fibers – Middle/inferior cerebellar peduncles – Labyrinthine artery	– Facial paralysis (LMN) – Reduced lacrimation, salivation, and taste (anterior 2/3 tongue) – Vertigo, nystagmus – Contralateral pain/temp loss (body), ipsilateral face – Ipsilateral Horner syndrome, ataxia, sensorineural deafness	Lateral pontine syndrome “Facial droop means AICA’s pooped”
Basilar Artery	– Pons, medulla, lower midbrain – Corticospinal and corticobulbar tracts – Ocular cranial nerve nuclei, paramedian pontine reticular formation	– Quadriplegia – Loss of voluntary facial, mouth, tongue movement – Loss of horizontal eye movement (vertical spared)	Locked-in syndrome
Posterior Cerebral Artery (PCA)	Occipital lobe	– Contralateral hemianopia with macular sparing – Alexia without agraphia (dominant hemisphere)

Table of Stroke Effects by Artery

Points to Remember

Middle Cerebral Artery (MCA): Major artery for face and upper limb control; aphasia in the dominant hemisphere.
Anterior Cerebral Artery (ACA): Involved in lower limb function; leads to urinary incontinence.
Lenticulostriate Artery: Common in pure motor strokes, frequently impacted by hypertension.
Anterior Spinal Artery (ASA): Medial medullary syndrome presents with contralateral motor and proprioceptive loss.
Posterior Inferior Cerebellar Artery (PICA): Lateral medullary (Wallenberg) syndrome; unique “don’t pick a horse” mnemonic.
Anterior Inferior Cerebellar Artery (AICA): Causes facial paralysis and is associated with hearing issues.
Basilar Artery: Locked-in syndrome occurs due to brainstem involvement.
Posterior Cerebral Artery (PCA): Visual cortex damage leads to specific visual field defects.

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Effects of strokes

Table of Stroke Effects by Artery

Points to Remember

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