Lateral Striate Artery Lesion

[rocketbooster]

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This artery, off the MCA, supplies the posterior internal capsule. The corticospinal + DCML+ALS run through this. Wouldn't a lesion here cause deficits in contralateral motor (hemiparesis, hemiplegia), touch/vibration and pain/temp?

First Aid only says contralateral hemiparesis and hemiplegia, while Wikipedia says the samething. Why are they leaving out the DCML+ALS components? Seems like they are not affected, but what why wouldn't they be if the posterior IC is being wiped out?

 

[loveoforganic]

From what I remember, different regions of the internal capsule do different things. Lesions of the thalamus and internal capsule can lead to both pure sensory and pure motor strokes. I don't really remember GSA and internal capsule though :/

 

[Phloston]

The rabbit hole always goes deeper doesn't it?

As far as what I remember, loveoforganic is right about the tendency for internal capsule vs thalamic lesions producing pure motor vs sensory deficits, respectively. I wouldn't stress yourself out over it. If there's long-standing hypertension and the guy gets a Charcot-Bouchard aneurysm, just look for contralateral motor deficits secondary to intraparenchymal haemorrhage (not subarachnoid). I feel like I'm telling you stuff you already know anyway.

 

[ijn]

At least for this level, what they'll do is give you a presentation of a pure motor stroke and make you ID the posterior limb of the internal capsule on a brain MRI. If they give you a presentation of a pure sensory stroke, they'll make you ID the thalamus on a brain MRI.

It's true the internal capsule contains sensory fibers, but for test question writing purposes, a pure motor lesion would have to happen at the posterior limb where your answer choices on MRI are anterior capsule/posterior capsule/thalamus/caudate/putamen etc. It's not saying it's impossible to get a sensory loss at the posterior limb, but given those specific options, it's the one place where a pure motor deficit could occur.