Vascular Lesions of the Brain

Brain stem vascular lesions

Occlusion of the anterior spinal artery causes medial medullary syndrome, presenting with inferior alternating hemiplegia.

  • Ipsilateral paralysis of tongue.
  • Contralateral hemiplegia.
  • Contralateral sensory deficits.

Occlusion of the posterior inferior cerebelllar artery causes lateral medullary syndrome featured

  • Contralateral hemianaesthesia of the body below the head.
  • Ipsilateral hemianaesthesia of the face.
  • Cerebellar dysfunction.
  • Speech and swallowing disorders.
  • Horners syndrome.

Occlusion of the paramedian branches of the basilar arteries causes middle alternating hemiplegia.

  • Contralateral hemiplegia.
  • Medial deviation of the eyeball.

Obstruction of the short circumferential arteries from the basilar artery cause

  • Ipsilateral cerebellar dysfunction
  • Autonomic disturbances
  • Contralateral hemianaesthesia

Occlusion of the mesencephalic branch of the posterior cerebral artery causes Weber's syndrome

  • Contralateral hemiplegia
  • Ipsilateral lateral deviation of the eyeball

Cerebral Cortical Vascular Lesions

Occlusion of the anterior choroidal artery causes a triad of:
  • Contralateral hemiplegia
  • Hemianopia
  • Hemi hyperacusis

Occlusion of anterior cerebral arteries may cause

  • Contralateral hemiplegia
  • Contralateral hemianaesthesia ( both mainly affect the lower limb)
  • Agnosia
  • Personality changes
Occlusion of the calcarine artery causes homonymous hemianopia with macular sparing (Tunnel vison)

Occlusion of the middle cerebral artery near the origin of its cortical branches causes

  • Contralateral hemiplegia , most marked in the upper extremity and face.
  • Contralateral loss of position sense and discriminatory touch.
  • Global aphasia if its on the dominant side.
  • Partial deafness.