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Anterior Cerebral Artery (ACA) Stroke
Anatomy
The anterior cerebral artery (ACA) supplies the medial one third of the superior cerebrum.
The superior frontal sulcus distinguishes the MCA from the ACA territories.
Clinical Deficits
Symptoms result from the ACA’s role in supplying blood to the frontal lobes and the medial surfaces of the parietal lobes, which are crucial for lower limb motor control, cognitive functions, and urinary continence.
- Contralateral Lower Limb Weakness: Most prominent in the leg due to the ACA's supply to motor areas affecting the lower extremity.
- Sensory Loss: Similar to motor weakness, there is often sensory impairment in the contralateral lower limb.
- Gait Disturbances: Patients may exhibit a slow, cautious, and possibly spastic gait, often described as a "magnetic gait."
- Behavioral and Cognitive Changes:
- Abulia (lack of initiative or spontaneity)
- Apathy
- Confusion
- Personality changes
- Impaired judgment or executive functioning
- Urinary Incontinence: Can occur, particularly in acute and severe cases, reflecting frontal lobe involvement in bladder control.
- Grasp Reflex: Reemergence of this primitive reflex can be observed.
- Bowel Incontinence: May also be present in more severe cases.