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Symptoms of stroke
What types of symptoms can strokes cause?
Focal weakness, numbness, facial asymmetry, or speech difficulties are classic presentations.
Altered level of consciousness, vertigo, and cranial nerve deficits are often seen with posterior circulation (vertebrobasilar/brain stem) and cerebellar strokes.
Here is the table which lists common stroke syndromes.
Diminished level of consciousness is unusual for ischemic strokes.
Stroke Syndromes
| Syndrome | Symptoms |
|---|---|
| Anterior cerebral artery | Contralateral leg > arm numbness and weakness; akinetic mutism/abulia (especially bilateral infarcts) |
| Middle cerebral artery | Ipsilateral eye deviation; contralateral face and arm > leg weakness, sensory loss, contralateral hemianopsia; aphasia (left) or neglect (right) |
| Posterior cerebral artery | Contralateral hemianopsia, memory loss |
| Top of the basilar | Coma or somnolence/inattention, cortical blindness |
| Brain stem infarction | Ataxia, vertigo, diplopia, “crossed” findings: contralateral weakness with ipsilateral cranial nerve deficits |
| Cerebellar infarction | Ataxia (unilateral appendicular or truncal), vertigo, nausea/vomiting |
| Lateral medullary (Wallenberg’s) syndrome | Loss of pain and temperature sensation from the contralateral body and ipsilateral face; dysarthria, dysphagia, ataxia, hiccups |
| Pure motor ∗ | Contralateral face/arm/leg weakness |
| Pure sensory ∗ | Contralateral face/arm/leg sensory loss |
| Sensorimotor ∗ | Contralateral face/arm/leg weakness and sensory loss |
| Ataxic hemiparesis ∗ | Contralateral ataxia out of proportion to mild weakness |
| Clumsy hand dysarthria ∗ | Weak face and clumsy ipsilateral hand, dysarthria, dysphagia |
∗ The five classic lacunar syndromes result from occlusion of a single penetrating artery, which may be caused by small vessel vasculopathy, cardioembolism, or large artery atherosclerosis.
