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Hemiparesis dengan gangguan sensorik kontralateral sisi lesi Hemianopia kontralateral sisi lesi Gangguan fungsi luhur: misal afasia, hemineglect, gangg. Visuospatial, agnosia, apraksia 1. Defisit motorik/sensorik + hemianopia 2. Defisit motorik/sensorik+ gangguan funsi luhur 3. Gangg. Fungsi luhur + hemianopia 4. Defisit motorik/sensorik murni yg kurang ekstensif dibandingkan infark lakunar ( hanya monoparesis/monosensorik) 5. Gangguan fungsi luhur saja Salah satu a/b/c plus d a. Pure motorik stroke b. Pure sensory stroke c. Ataxic hemiparesis (termasuk ataxia dan paresis krural unilateral, dysartriaclumpsy-hand syndrome) d. Tidak boleh ada gejala berikut: -defisit visual -gangg. Fungsi luhur -gangg. Fungsi batang otak -hanya menunjukkan gangguan propioseptor saja a. b. c. d. e. f. Disfungsi saraf kranial ipsilateral dan gangg. Motorik/sensorik kontralateral Gangg. Motorik/sensorik bilateral Gangg. Gerakan konjugat mata Disfungsi serebelar tanpa gangg. Longg-tract ipsilateral Isolated hemianopia atau buta kortikal Penurunan kesadaran cukup berat karena gangg. Traktus retikularis
Cortical (Cortical Gray Matter,Lobar White Matter) Consciousness Cognitive (Aphasia,etc) Articulation Visual Fields Gaze paresis Motor Deficits Pattern of motor deficits Sensory deficits Pattern of sensory deficits Motor and sensory deficits Stunned to drowsy Prominent Rarely Dysarthria Defect present Common Usually present Face,arm,leg unequally Usually present Face,arm,leg unequally Usually parallel
Subcortical (Basal Ganglia,Thalamus, Internal Capsule) Normal Absent or Mild Dysarthria Defect rarely present Rare Absent or present Face,arm,leg equally Absent or present Face,arm,leg equally Usually isolated motor/sensory
Major (Both cortical and subcortical) Drowsy to stupor Prominent Dysarthria Defect present Extremely common Prominent Face,arm,leg equally Prominent Face,arm,leg equally Usually parallel
Infarct Often history of transient ischemic attack Often onset at rest Minimal cranial discomfort (often none) Focal neurologic deficit increasing in stepwise fashion, consciousness intact early Moderately high normotensive) blood pressure (ocassionaly
Intracerebral Hemorrhage No history of transient ischemic attack Onset during activity Headache(Often severe) Rapidly advancing neurologic (1 to 5 hours), State of consciousness declining to coma Severe high blood pressure (ocassionaly moderately high blood pressure) Blood in cerebrospinal fluid CT scan shows hemorrhage