There is a list of "classical" stroke syndromes arranged by arterial terriotry, which one needs to commit to memory. This list includes dominant and non-dominant MCA infarction, medial and lateral medullary syndromes,  anterior and posterior cerebral artery syndromes and the basilar artery syndrome.The Internet Stroke Centre has an excellent summary of stroke syndromes. It is the main source for this summary. It even has references to the studies which describe each specific  stroke syndrome. Thus far, the college has not expected its candidates to make this sort of diagnosis in the SAQs, perhaps with the exception of Question 10.1 from the second paper of 2013 and Question 27 from the first paper of 2019, both of which asked about lateral medullary syndrome.

Medial medullary syndrome: anterior spinal artery or vertebral artery

  • Contralateral weakness
  • Contralateral vibration and proprioception sensory loss
  • Ipsilateral tongue weakness

Lateral medullary syndrome: vertebral, basilar, anterior spinal artery, or PICA

  • On the side of the lesion:
    • Facial sensory loss
    • Nystagmus
    • Horner's syndrome
    • Loss of gag reflex
    • Ipsilateral ataxia with a tendency to fall to the ipsilateral side
  • On the contralateral side:
    • Pain and temperature sensory loss in the extremities
  • Generally:
    • Vertigo
    • Nausea
    • Dysphagia

Locked-in syndrome: basilar artery

  • Bilateral whole-body weakness
  • Bilateral facial weakness
  • Lateral gaze weakness
  • Dysarthria

Essentially, this syndrome (the infarction of the whole ventral pons) results in paralysis of all movements except vertical gaze and eyelid opening.

Gerstmann syndrome: dominant MCA

  • Agraphia
  • Acalculia
  • Finger agnosia
  • Right-left disorentation
  • Contralateral weakness
  • Contralateral sensory loss
  • Contralateral hemineglect
  • Contralateral homonymous hemianopia
  • Global aphasia (receptive and expressive)

Middle cerebral artery syndrome: non-dominant MCA

  • Contralateral weakness
  • Contralateral sensory loss
  • Contralateral hemineglect
  • Contralateral homonymous hemianopia
  • Apraxia
  • Spatial disorientation

Posterior cerebral artery syndrome - distal lesions

  • Contralateral homonymous hemianopia (or cortical blindness)
  • Visual agnosia

Posterior cerebral artery syndrome - proximal lesions

  • Contralateral homonymous hemianopia (or cortical blindness)
  • Contralateral hemiplegia
  • Chorea and hemiballismus
  • Oculomotor nerve palsy, loss of voluntary eye movements
  • Thalamic pain/hyperalgesia syndrome

Anterior cerebral artery syndrome

  • Contralateral hemiparesis of lower limbs
  • Contralateral sensory loss of lower limbs
  • Anosmia- olfactory bulb is infarcted


Oh's Intensive Care manual: Chapter   51   (pp. 568)  Acute  cerebrovascular  complications by Bernard  Riley  and  Thearina  de  Beer. This chapter of Oh's has the distinction of having very few tables in it - there are only two, for an extremely long block of text.

Qureshi, Adnan I., et al. "Spontaneous intracerebral hemorrhage." New England Journal of Medicine 344.19 (2001): 1450-1460.

Caplan, L. R. "Basic Pathology, Anatomy, and Pathophysiology of Stroke." Caplan’s Stroke A Clinical Approach (2009): 23-4.