Types of Strokes 

It are the classified by etiologic categories (embolus, thrombosis, or hemorrhage), specific
 vascular territory (anterior cerebral artery syndrome middle cerebral artery syndrome.), and management
 categories (minor stroke, major stroke, deteriorating stroke, young stroke, transient ischemic attack ).

Here we will explain both the vascular and management category 

Etiologic Categories

Thrombosis

The stroke occurring because the thrombus (blood clot)block the  major blood vessels of brain which stop the oxygen supply in various parts of brain. The formation of thrombus occur inside blood vessels or the chamber of heart .     

Embolus

The stroke occurring because the emboli (blood clot or other foreign material such as, tumor cells)  block the major blood vessels of brain which stop the oxygen supply in various parts of brain. The formation of emboli occur inside blood vessels or the chamber of heart .     

Hemorrhage

The stroke occurs because of the rupture of the major blood vessels which lead to blood accumulation in various parts of the brain.

Vascular Category 

The vascular category means the stroke occurs due to damage in major and minor blood vessels of the brain or a circle of wills. It consists of Anterior Cerebral Artery Syndrome, Middle Cerebral Artery Syndrome, Internal Carotid Artery Syndrome, Posterior Cerebral Artery Syndrome, Lacunar Stroke, and vertebrasilar artery Syndrome. Let us understand them individually. 

 Anterior Cerebral Artery Syndrome (ACA)

The anterior cerebral artery (ACA) is the first and smaller of two terminal branches of the internal carotid artery is blocked (infarct) causing no blood supply in the anterior regions of the brain resulting in anterior Cerebral Artery Syndrome.

It supplies the medial aspect of cerebral hemisphere (frontal and parietal lobes) and subcortical structures, including basal ganglia ( inferior caudate nucleus, anterior internal capsule.), anterior fornix, and anterior four-fifths of the corpus callosum.

Sign and symptoms 

The most common characteristics of ACA disorder include contralateral hemiparesis and sensory loss with greater involvement of the lower extremity (LE) than the upper extremity (UE). Other symptoms are 

• Urinary incontinence 
• Apraxia
• Abulia (akinetic mutism)
• Contralateral grasp reflex, sucking reflex

Middle Cerebral Artery Syndrome

The middle cerebral artery (MCA) is the second of the internal carotid artery’s two main branches blocked (infarct), causing no blood supply in the brain’s middle regions, resulting in MCA syndrome.

It supplies the entire lateral aspect of the cerebral hemisphere (frontal, temporal, and parietal lobes) and subcortical structures, including the internal capsule (posterior portion), corona radiata, Globus pallidus (outer part), most of  caudate nucleus, and the
putamen.

Sign and symptoms 

The most common characteristics of MCA syndrome are contralateral spastic hemiparesis(weakness ) and sensory loss of the face, UE, and LE, with the face and UE more involved than the LE. Other symptoms are as follows

• Motor speech impairment: Broca or nonfluent aphasia with limited vocabulary and slow, hesitant speech
• Receptive speech impairment: Wernicke or fluent aphasia with impaired auditory comprehension and fluent speech with normal rate and melody
• Global aphasia: nonfluent speech with poor comprehension
• Perceptual deficits: unilateral neglect, depth perception, spatial relations, agnosia
• Limb-kinetic apraxia
• Loss of conjugate gaze to the opposite side
• Ataxia of contralateral limb(sensory ataxia)

Posterior Cerebral Artery Syndrome

The two posterior cerebral arteries (PCAs) arise as terminal branches of the basilar artery are blocked (infarct), causing no blood supply in the brain’s posterior regions, resulting in PCA syndrome. 

They supply the corresponding occipital lobe and medial and inferior temporal lobe. They also supply the upper brain stem, midbrain, and posterior diencephalon, including most of the thalamus. 

Sign and symptoms 

• The patient will have a contralateral sensory loss(the medical term is Hemianesthesia ).
• The might feel central post-stroke (thalamic )pain.
• The person will have difficulty in reading and writing.
• medical terms are dyslexia and agraphia ) 
• Sometimes he/she might have a problem naming people on sight. 
• Temporal lobe ischemic can result in memory loss (the medical term is amnesia ) 

Lacunar Stroke 

Lacunar strokes are caused by small vessel disease deep in the cerebral white matter (penetrating artery disease). When one or more small arteries are involved in hemorrhage or become blocked, resulting in ischemia of a small area is called  lacunar syndromes /lacunar stroke .

Sign and symptoms 

• These types of Patients feel central post-stroke (thalamic) pain.
• Weakness or numbness usually on one side of face, arm, or leg etc.
• The person will have difficulty in reading and writing.
• Difficulty in walking
• Vision changes (blurred vision, double vision)
• Difficulty with swallowing
• Dizziness or vertigo

Vertebrobasilar Artery Syndrome

The occlusion in  vertebral arteries which arise from the subclavian arteries and travel into the brain along the medulla where they merge at the inferior border of the pons to form the basilar artery causes Vertebrobasilar Artery Syndrome

These  arteries supply the cerebellum (via posterior inferior cerebellar arteries) and the medulla (via the medullary arteries). The basilar artery supplies pons (via pontine arteries), the internal ear (via labyrinthine arteries), and the cerebellum (via the anterior inferior and superior cerebellar arteries). The basilar artery then terminates at the upper border of the pons, giving rise to the two posterior arteries

• The Patients develop acute hemiparesis rapidly progressing to tetra plegia and lower bulbar paralysis (CNs V through XII are involved).
• Initially, the patient is dysarthric and dysphonic but rapidly progresses to mutism (anarthria).
• The patient cannot move or speak but remains alert and oriented. There is no loss of consciousness and sensation
• t cannot move or speak but remains alert and oriented. Horizontal eye movements are impaired, but vertical eye movements and blinking remain intact.

Extracranial injuries such as ,Forceful neck motions (e.g., whiplash or aggressive neck manipulations) to the vertebral arteries as they travel through the cervical spine can also produce verte brobasilar signs and symptoms.

• Dizziness and vertigo
• Nausea and vomiting
• Double vision
• Slurred speech
• Weakness, numbness, or tingling in face , arm or leg
• Difficulty in swallowing or dysphagia
• Nystagmus