Which physical findings help locate the lesions of vertebrobasilar stroke?

Updated: Mar 03, 2020
  • Author: Vladimir Kaye, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

Certain constellations of findings may serve as clues to the location of the lesion, including the following examples:

  • Midbrain syndromes - cranial nerve (CN) III lesion and vertical gaze palsy

  • Pontine syndromes - CN VI lesion, horizontal gaze palsy, and VII nerve palsy

  • Medullary syndromes - ipsilateral facial pain and temperature loss, Horner syndrome, ipsilateral ataxia, contralateral loss of pain and temperature sensation, and ipsilateral paralysis of the tongue, soft palate, vocal cord, or sternocleidomastoid [SCM] muscle

  • Posterior cerebral artery - contralateral hemianopia with macular sparing


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