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72yo male, acute right Hemiparesis and right facial droop (Stroke Mimics…

- - - - Lateral Gaze Weakness (CN VI)
        
        Ventral Pontine Syndrome (Millard-Gubler) basilar a.: short circumferential br / paramedian br.
        
        Contralateral loss of pain and temp sensation
        
        Lateral pontine syndrome (basilar – long circumferential br / AICA)
        
        Ipsilateral limb ataxia
        
        CN VIII lesion – ipsilateral hearing loss, vertigo, and nystagmus
    - - Ipsilateral Oculomotor nerve palsy: drooping eyelid, fixed wide pupil pointing down and out -> diplopia
        
        Weber Syndrome (midbrain infarct – paramedian branches of PCA / Basilar bifurcation perforating arteries)
      - Lateral Gaze Weakness (CN VI) / Ipsilateral ataxia / Contralateral loss of proprioception and vibration (medial lemniscus)
        
        Inferior medial pontine syndrome (Foville) Paramedian br / Short circumferential a. of basilar a.
      - Sensory loss of contralateral face, arm, and leg
        
        Ataxia of contralateral extremities
        
        Lacunar Infarct
        
        Middle Cerebral Artery Infarct
        
        Speech impairment (Broca’s, Wernicke’s or Global aphasia
        
        Perceptual deficits
        
        Visual Disorder (Deviation conjuguee – gaze toward size of lesion; contralateral homonymous hemianopia)
        *may be expressive in anterior MCA territory infarction (Broca), receptive in posterior MCA stroke (Wernicke), or global with extensive infarction
        
        Total anterior circulation syndrome (All 3) / Partial Anterior Circulation syndrome (2/3)
        
        Contralateral motor or sensory deficit
        
        Homonymous hemianopia
        
        Higher cortical dysfunction
    - - Ventral Pontine Syndrome (Raymond) – Paramedian br.