STROKE-PRESENTATION, ACA TERRITORY
SUMMARY
1. The ACA supplies the medial part of the hemisphere from the lamina terminalis to the cuneus, accounts for 3% of all strokes[1]
2. Gacs G, Fox AJ, Barnett HJ, Vinuela F. Occurrence and mechanisms of occlusion of the anterior cerebral artery. Stroke 1983; 14(6):952-959.
3. Kazui S, Sawada T, Naritomi H, Kuriyama Y, Yamaguchi T. Angiographic evaluation of brain infarction limited to the anterior cerebral artery territory. Stroke 1993; 24(4):549-553.
4. Kumral E, Bayulkem G, Evyapan D, Yunten N. Spectrum of anterior cerebral artery territory infarction: clinical and MRI findings. Eur J Neurol 2002; 9(6):615-624.
[2][3][4]
DEFICITS
2. Contralateral weakness/sensory loss affecting the legs more than the upper limbs
3. Abulia (bilateral involvement)
4. Urinary incontinence (bilateral involvement)
5. Transcortical motor aphasia (on the left)
6. Gait apraxia
7. Contralateral grasp reflex & paratonic rigidity
SYNDROMES
8. If the corpus callosum is affected, patients may develop tactile agnosia which is an inability to recognize objects by touch
9. Gengenhalten: urinary incontinence with grasp reflex & paratonic rigidity
10. Bilateral ACA involvement: paraplegia, frontal lobe deficits (personality disorders, disinhibition, abulia), urinary incontinence, aphasia
Reference(s)
- ↑ Bogousslavsky J, Regli F. Anterior cerebral artery territory infarction in the Lausanne Stroke Registry. Clinical and etiologic patterns. Arch Neurol 1990; 47(2):144-150.
- ↑ Gacs G, Fox AJ, Barnett HJ, Vinuela F. Occurrence and mechanisms of occlusion of the anterior cerebral artery. Stroke 1983; 14(6):952-959.
- ↑ Kazui S, Sawada T, Naritomi H, Kuriyama Y, Yamaguchi T. Angiographic evaluation of brain infarction limited to the anterior cerebral artery territory. Stroke 1993; 24(4):549-553.
- ↑ Kumral E, Bayulkem G, Evyapan D, Yunten N. Spectrum of anterior cerebral artery territory infarction: clinical and MRI findings. Eur J Neurol 2002; 9(6):615-624.
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
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