TEST2 | STROKE MANUAL

pure sensory stroke (thalamic lesions)
pure hemiparesis (PMH) – most often internal capsule, pons
- PMH with horizontal gaze palsy
- PMH with crossed CN III palsy (Weber syndrome)
- PMH with crossed CN VI palsy (Millard-Gubler)
- PMH with confusion
- PMH with internuclear ophthalmoplegia (INO)
- pure face-saving hemiparesis (PMH)
sensorimotor stroke (thalamocapsular) – internal capsule, thalamus
dysarthria syndrome – clumsy hand
atactic hemiparesis (pons)
PMH +
- PMH with horizontal gaze palsy
- PMH with crossed CN III palsy (Weber syndrome) – brainstem
- PMH with crossed CN VI palsy (Millard-Gubler) – brainstem
- PMH with confusion (thalamic dementia)
- PMH with internuclear ophthalmoplegia (INO)
- pure face-saving hemiparesis (PMH)
hemiballism-hemichorea and acute dystonia (contralateral subthalamic and putaminal-pallidal regions and the posterolateral thalamus)
cerebellar ataxia with crossed palsy n.III (Claude’s syndrome)

*Hunt-Hess grading system*
Grade	Description	Probability of severe morbidity/ mortality
0	unruptured aneurysm – incidental finding	–
1	asymptomatic mild headache and/or mild nuchal rigidity	22 %
2	lucidity cranial nerve palsies moderate to severe headache, meningeal syndrome	22 %
3	somnolence, lethargy, or confusion mild focal neurological deficits	50 %
4	stupor moderate to severe hemiparesis early decerebrate rigidity (posturing)	87 %
5	deep coma decerebrate rigidity (posturing) moribund appearance	100 %