Stroke should be suspected in anyone presenting with an acute onset, ongoing focal neurological deficit that cannot be explained by hypoglycaemia or other stroke mimics.
Stroke is defined as a clinical syndrome, caused by cerebral infarction (85% of cases) or haemorrhage (15% of cases), characterised by rapidly developing signs of focal and global disturbance of cerebral functions lasting more than 24 hours or leading to death.
|Blood Vessel Affected||Structures supplied||Clinical Features|
|Anterior cerebral artery||Frontal lobe||Contralateral leg weakness, Contralateral sensory loss, Behavioural abnormalities, Personality change, Urinary incontinence|
|Middle cerebral artery||Frontal lobe, Temporal lobe, Parietal lobe, Basal ganglia and Internal capsule||Contralateral hemiplegia (face/arm > leg), Contralateral sensory loss, Expressive or receptive dysphasia (if dominant lobe), Contralateral neglect (if non-dominant lobe)|
|Posterior cerebral artery||Temporal lobe, Occipital lobe||Contralateral homonymous hemianopia|
|Vertebral-basilar arteries||Cerebellum, Brainstem||Cerebellum: Dysdiadochokinesia, ataxia, nystagmus, intention tremor, slurred speech, hypotonia (DANISH)
Brainstem:Hemiparesis/quadriplegia, sensory loss, diplopia, dysconjugate gaze, slurred speech, dysphagia, decreased consciousness, abnormal respiration
Functional Anatomy of the Brain
Middle Cerebral Artery Ischaemic Stroke
Image by Lucien Monfils derivative work: Suraj (INFARCT.jpg) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons.
Image by Rhcastilhos (Gray519.png) [Public domain], via Wikimedia Commons.