A 56-year-old repos to the ER and on attempting to take a history, she is having difficulty answering questions. Her daughter repos that this is not normal and gives the history on her mother’s behalf. She repos that, for the past two hours, her mother has been unable to lift her right arm and is struggling walking. On examination, there is reduced power (3/5) in all myotomes of her right arm and leg. There is facial drooping on the right-hand side that spares the forehead. Visual field tests elicit a right homonymous hemianopia. She is unable to speak but is able to follow commands. According to the Oxford Stroke Classification what stroke is this?
Correct Answer: Total Anterior Circulation Stroke (TACS)
Description: Oxford Stroke Classification Type of infarct Criteria and features Total anterior circulation infarct (TACI) Combination of all 3: 1. Unilateral hemiparesis and/or hemisensory loss of face, arm and legs-(motor and sensory coex affected) 2. Homonymous hemianopia (involvement of the optic radiation) 3. Higher cognitive dysfunction: - Expressive or receptive Dysphasia (Dominant hemisphere involved) - Visual and sensory inattention - Neglect(Non dominant hemisphere involved) Paial anterior circulation infarcts (PACI) 2/3 of the criteria for TACI Lacunar Infarction (LACI) Coex is spared(No higher coical function defect) One of the following is needed for diagnosis: - Pure motor hemiparesis - Pure hemi sensory loss - Sensorimotor stroke - Ataxic hemiparesis - Dysahria Posterior Circulation Infarction (POCI) "Crossed" syndromes, with I/L cranial nerve palsy C/L motor and/or sensory deficit Features include: - Ataxia - Cerebellar syndrome - Horner's Syndrome - Isolated homonymous hemianopia (occipital lobe supplied by posterior cerebral aery) - Coical blindness (basilar aery occlusion affecting both occipital coices)
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