STROKE (PoCI)
Refer ischaemic
stroke card for other detail.
BIOLOGICAL BEHAVIOUR
Pathophysiology
Could be caused by occlusion of vertebral, basilar, or posterior cerebral
arteries.
Affects pons, brainstem, cerebellum.
Ipsilateral cranial nerve palsies.
Contralateral motor (corticospinal) and/ or sensory (thalamus, medial lemniscus,
spinothalamic) deficits.
Cerebellar syndromes.
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MANIFESTATIONS
Cranial Nerves
Ipsilateral palsy.
Corticospinal tract
Contralateral motor deficit.
Bilateral if basilar artery occluded.
Thalamus, medial lemniscus
Gracile and cuneate fasciculus of the dorsal columns.
Loss of touch and vibration sensation.
Spinothalamic tract
Loss of pain and temperature sensation.
Cerebellum
Loss of balance and coordination (ipsilateral).
Other cerebellar deficits.
Occipital cortex
Loss of half the visual field.
Contralateral homonymous hemianopia.
RAS
Permanent coma, death.
Vestibular nuclei
Nystagmus, vertigo, vomiting.
Ventral pons
(corticospinal, corticobulbar pathways)
Locked-in syndrome (unable to move, sensation and RAS unaffected).
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