Artery involved | Syndrome |
Anterior cerebral artery | Motor and/or sensory deficit (leg > face, arm) Grasp, sucking reflexes Abulia, paratonic rigidity, gait apraxia |
Middle cerebral artery | Dominant hemisphere: aphasia, motor and sensory deficit (face, arm > leg > foot), may be complete hemiplegia if internal capsule involved, homonymous hemianopia Non-dominant hemisphere: neglect, anosognosia, motor and sensory deficit (face, arm > leg > foot), homonymous hemianopia |
Posterior cerebral artery | Homonymous hemianopia; alexia without agraphia (dominant hemisphere); visual hallucinations, visual perseverations (calcarine cortex); sensory loss, choreoathetosis, spontaneous pain (thalamus); III nerve palsy, paresis of vertical eye movement, motor deficit (cerebral peduncle, midbrain) |
Penetrating vessels | Pure motor hemiparesis (classic lacunar syndromes) Pure sensory deficit Pure sensory-motor deficit Hemiparesis, homolateral ataxia Dysarthria/clumsy hand |
Vertebrobasilar | Cranial nerve palsies Crossed sensory deficits Diplopia, dizziness, nausea, vomiting, dysarthria, dysphagia, hiccup Limb and gait ataxia Motor deficit Coma Bilateral signs suggest basilar artery disease |
Internal carotid artery | Progressive or stuttering onset of MCA syndrome, occasionally ACA syndrome as well if insufficient collateral flow |