Anterior cerebral artery syndrome is a condition whereby the blood supply from the anterior cerebral artery (ACA) is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel: the medial aspects of the frontal and parietal lobes, basal ganglia, anterior fornix and anterior corpus callosum.Depending upon the area and severity of the occlusion, signs and symptoms may vary within the population affected with ACA syndrome. Blockages to the proximal (A1) segment of the vessel produce only minor deficits due to the collateral blood flow from the opposite hemisphere via the anterior communicating artery. Occlusions distal to this segment will result in more severe presentation of ACA syndrome. Contralateral hemiparesis and hemisensory loss of the lower extremity is the most common symptom associated with ACA syndrome. Signs and symptoms
Hemiparesis or hemiplegia contralaterally, involving primarily the lower limbs and pelvic floor musculature
Sensory deficits contralaterally, involving primarily the leg and perineum
Apraxia (due to branches to the supplementary motor area and corpus callosum)
Disconnection syndrome (due to callosal branches)
Anosmia (due to branches of the olfactory bulb and olfactory tract)
Urinary incontinence
Grasp reflex and or sucking reflex contralaterally (if circle of Willis compromised)

Diagnosis
Once an acute ischemic stroke is suspected, the standard evaluation includes performing routine airway, breathing and circulation assessment, checking blood glucose, performing a validated stroke severity scale assessment and accurate, focused history regarding the time of symptom onset or last known well or at baseline.
Diagnosis
LGL syndrome is diagnosed in a person who has experienced episodes of abnormal heart racing (arrhythmias) who has a PR interval less than or equal to 0.12 second (120 ms) with normal QRS complex configuration and duration on their resting ECG. A short PR interval found incidentally on an ECG without episodes of tachycardia is simply a benign ECG variant.LGL can be distinguished from WPW syndrome because the delta waves seen in WPW syndrome are not seen in LGL syndrome. The QRS complex will also be narrow in LGL syndrome, as opposed to WPW, because ventricular conduction is via the His-Purkinje system. Lown–Ganong–Levine syndrome is a clinical diagnosis that came about before the advent of electrophysiology studies. It is important to be aware that not all WPW ECGs have a delta wave; the absence of a delta wave does not conclusively rule out WPW. Prognosis
Individuals with LGL syndrome do not carry an increased risk of sudden death. The only morbidity associated with the syndrome is the occurrence of paroxysmal episodes of tachycardia which may be of several types, including sinus tachycardia, atrioventricular nodal re-entrant tachycardia, atrial fibrillation, or atrial flutter. See also
Cardiac electrophysiology
Electrocardiogram
Electrophysiology study
Premature ventricular contraction
Wolff–Parkinson–White syndrome

References


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