Clinical aspect of arteries

Anterior cerebral artery

Blockage of anterior cerebral artery or its branches

Clinical features

  • 1. Paralysis of opposite foot and leg- motor leg area on homonculus

  • 2. Opposite paresis (minimal)- corona radiata involvement

  • 3. Sensory loss (cortical) on toes, foot and leg- sensory area for foot and leg on sensory cortex

  • 4. Unwitting urinary incontinence- sensorimotor area in the paracentral lobule

  • 5. Contralateral grasp reflex: medial surface of posterior frontal lobe

  • 6. Abulia - lesion is uncertain

  • 7. Impairement of gait and stance - Frontal cortex

  • 8. Mental impariment and affection of memory- unknown

  • 9. Dyspraxia of left limbs, Tactile aphasia pf left limbs - all via the corpus callosum

  • 10. Cerebral paraplegia bilateral lesion of anterior cerebral artery

 

Middle cerebral artery

Clinical features of middle cerebral artery blockage.

  • 1. Paralysis of contralateral face, arm and leg- somatic motor area

  • 2. Motor aphasia- Dominant hemispheres speech area

  • 3. Central aphasia word deafness- Speech area and parieto-occipital cortex of dominant hemisphere

  • 4. Conduction aphasia- Central speech area

  • 5. Apractognosia- Non dominant suprasensory zone which corresponds to speech area in dominant hemisphere

  • 6.Homonymous hemianopsia- Optic radiation deep to the second temporal convolution

  • 7. Paralysis of conjugate gaze to the opposite side- frontal contraversive field

  • 8. Avoidance reaction of opposite limbs- parietal lobe lesion

  • 9. Frontal ataxia- frontopontine tract lesion

  • 10. Loss or impairment of optokinetic nystagmus-  affects supramarginal or angular gyrus

  • 11.Cerebral paraplegia- posterior limb of internal capsule.

 

 Posterior cerebral artery

This artery supplies the visual cortex, the thalamus and internal capsule

Signs

  • 1. Homonymous hemianopssia - calcarine sulcus

  • 2. Bilateral homonymous hemianopsia- bilateral occipital lobe

  • 3. Verbal dyslexia without agraphia, and with color anomia- dominant calcarine lesion

  • 4. Memory defect- hippocampal lesion

  • 5. Topographical disorientation nondominant calcarine and lingual gyri

  • 6. Simultanagnosia- dominant visual cortex

  • 7. Unformed visual hallucinations- calcarine cortex

  • 8. Thalamic syndrome - postero-anterior nucleus of thalamus

  • 9. Thalamoperforate syndrome- dentatothalamic tract

  • 10. Weber's syndrome- Third nerve and cerebral peduncle

  • 11. Contralateral hemiplegia- cerebral peduncle

  • 12. paralysis of vertical eye movement- nuclei of Cajal and Darkschewitsch

  • 13. Contralateral rhythmic, ataxic action tremor- dentatothalamic tract

 

Coronal section of brain at level of thalamus and basal ganglia-blood supply; red- middle cerebral artery, blue- posterior cerebral artery, green- anterior cerebral artery.

 

 

 

 

 

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