Complete MCA syndrome
The middle cerebral artery (MCA) syndrome refers to a collection of neurological signs and symptoms resulting from a stroke or other ischemic injury affecting the middle cerebral artery and the areas of the brain it supplies. A complete MCA syndrome typically involves the occlusion or severe stenosis of the middle cerebral artery, resulting in significant neurological deficits. Here are the key features of a complete MCA syndrome:
- Hemiparesis or Hemiplegia: Weakness or paralysis affecting one side of the body, typically contralateral (opposite) to the side of the brain affected by the stroke. This weakness or paralysis may be more pronounced in the face, arm, and leg, and it can range from mild to severe.
- Hemisensory Loss: Loss of sensation or abnormal sensation on one side of the body, corresponding to the area of the brain supplied by the middle cerebral artery. This sensory deficit may affect touch, temperature, proprioception (sense of body position), and pain perception.
- Homonymous Hemianopia: Visual field loss affecting one side of the visual field in both eyes. This occurs because the fibers of the optic tract from the contralateral (opposite) visual field cross over at the optic chiasm and travel through the posterior portion of the internal capsule, which is supplied by the middle cerebral artery.
- Aphasia or Dysphasia (If Dominant Hemisphere Affected): Language impairment affecting speech production, comprehension, reading, or writing. Aphasia occurs when the dominant hemisphere (usually the left hemisphere) is affected by the stroke. Dysphasia refers to less severe language impairment.
- Neglect or Inattention (If Non-dominant Hemisphere Affected): Lack of awareness or attention to stimuli on one side of the body or in the environment. Neglect typically occurs when the non-dominant hemisphere (usually the right hemisphere) is affected by the stroke.
- Gaze Preference Towards the Side of the Lesion: The eyes may deviate towards the side of the brain affected by the stroke, particularly if the frontal eye fields are involved.
- Frontal Lobe Dysfunction: Depending on the extent and location of the stroke, additional symptoms may include executive dysfunction, personality changes, and cognitive impairments.
The severity and specific manifestations of a complete MCA syndrome can vary depending on factors such as the size, location, and extent of the ischemic injury within the territory supplied by the middle cerebral artery. Prompt recognition and treatment of MCA strokes are essential to minimize neurological deficits and improve outcomes.