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For further information, see CMDT Part 24-09: Stroke

Key Features

  • Small lesions (usually < 1.5 cm in diameter) occur in the distribution of

    • Short, penetrating arteries in the basal ganglia

    • Pons

    • Cerebellum

    • Internal capsule

    • Thalamus

    • Deep cerebral white matter (less common) (Table 24–3)

  • Risk factors include poorly controlled hypertension and diabetes mellitus

  • Generally has a good prognosis, with partial or complete resolution often occurring over 4–6 weeks

Clinical Findings

  • There are several clinical syndromes

    • Contralateral pure motor hemiparesis or pure hemisensory deficit

    • Ipsilateral ataxia with crural paresis

    • Dysarthria with clumsiness of the hand

  • Deficits may progress over 24–36 hours before stabilizing

Table 24–3.Features of the major stroke subtypes.

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