Syndrome Vertebrobasilar Stroke

Table 1

Anatomic Region Function Vascular Supply Clinical Features

Syndrome Ipsilateral Contralateral

Cerebellum

Regulation and control of muscle tone, coordination, control of posture and gait

• Vertebral artery

• Posterior inferior cerebellar artery

Anetrior vermis Gait, trunk and leg dystaxia

Posterior vermis Truncal ataxia

Midbrain

Modulation of sensation, movement and consciousness

• Posterior cerebral artery

Weber 3rd nerve palsy Hemiplegia- arm & leg

Claude 3rd nerve palsy Cerebellar ataxia, tremor,

Benedikt 3rd nerve palsy Cerebellar ataxia, tremor and corticospinal signs

Parinaud

Paralysis of upward gaze and accommodation, fixed pupils

-

Pons

Modulation of sensation, movement and consciousness

• Basilar artery

Locked-in syndrome

Bilateral hemiparesis- arm & leg, facial weakness, lateral gaze weakness, dysarthria

Foville Lateral gaze weakness, facial

Hemiparesis- arm & leg

weakness

Millard-Gubler Lateral gaze weakness, facial weakness

-

Raymond Lateral gaze weakness

Hemiparesis- arm & leg

• Basilar artery

• Anterior inferior cerebellar artery

Marie-Foix Arm and leg ataxia Hemiparesis- arm & leg Hemisensory loss- pain & temperature

Medulla

Modulation of sensation, movement and consciousness

• Vertebral artery

• Posterior inferior cerebellar artery

Wallenberg (Lateral Medullary)

Nystagmus, Vertigo, Ataxia, Sensory loss in face, Hoarseness, Dysphagia, Horner syndrome

Hemisensory loss- pain and temperature

• Anterior Spinal artery

Medial Medullary

Weakness and later hemiatrophy of tongue

Hemiparesis- arm & leg, Hemisensory loss- touch and proprioception

Cerebrum

• Occipital lobe

• Visual perception & recognition

• Posterior cerebral artery

Balint Bilateral loss of voluntary eye movements, poor visual-motor coordination, inability to

• Infero-medial temporal lobe

• Visual discrimination

•

understand visual objects

• Posterior cerebral artery

• Top of Basilar

Anton Bilateral loss of vision, unawareness or denial of blindness

Thalamus Integration of sensory and motor systems

• Posterior cerebral artery

Dejerine-Roussy - Hemisensory loss- all modalities, hemi-body pain