Download MBBS Clinical Features of Capsuloganglionic Stroke Lecture PPT

? Lacunar infarcts
atherothrombotic/lipohyalinotic occlusion
- small penetrating artery---
infarction of deep brain
tissue(<1cm)

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*small vessel stroke*
*lacunalake of fluid--autopsy
FISHER'S CADAVER DISSECTION
* lacunar infarctslacunar areas in
brainlacunar syndromes

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? LACUNAR SYNDROMES
1. Pure motor hemiparesis
2. Pure sensory stroke
3. Ataxic hemiparesis
4. Dysarthria clumpsy hand syndromes

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5. Mixed sensorimotor stroke

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PURE MOTOR HEMIPARESIS
? Occlusion of a lenticulostriate
vesselstroke within int.capsule(
genu/pl)....+infarcts in corona radiata or pons

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? Face armleg
? Face=arm=leg
? +no sensory loss/homonymous hemianopia/
aphasia /hemineglect
? D/S COURSETIAs(capsular warning

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syndromes(48hrs) in 30% cases-
stuttering course
? Incomplete paresisgud prognosis

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PURE SENSORY STROKE
? LESS COMMON6-7% OF LS

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? Sites: corona radiata, post limb ,thalamus
? Sensation decreased for all sens modalities
over one half of body...pins n needle+/-
? No hemiparesis+no visual field defect+ no
brainstem dysfn +no memory loss/dyslexia

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? De-Jerine roussy syndrome
? complication'severe intractable pain
+allodynia on affected side
? Days or months after stroke often appear whn
the sensory loss is improving

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? ReliefTCAs or gabapentin

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MIXED SENSORIMOTOR STROKE
? c/l weakness +sensory loss
? No visual loss /language/cognitive disturbance.
? Infarcts involving IC + THALAMUS

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ATAXIC HEMIPARESIS
? Weakness of LL esp ankle n toes+ babinsky(+)
+dysmetria os arm n leg.
? Coordin >>weakness
? 5 sites

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? Prognosis? usually weakness improves n
ataxia remains

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Dysarthria clumpsy hand syndrome
? Dysarthria and ataxia of upper limb
? Othersfacial

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weakness,dysphagia,varying degree of
weakness in arm and leg
? Int capsule... rarely pons

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