Anterior cerebral artery syndrome
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 lobe and parietal lobes, basal ganglia, anterior fornix and anterior corpus callosum.
Clinical features
Akinetic mutism seen in bilateral frontal lobe dysfunction, (due to bilateral anterior cerebral artery infarct after vasospasm of anterior communicating artery aneurysm rupture or with large bilateral frontal lesions; may actually be abulia) or with bilateral cingulate gyrus lesions.
Hemiparesis or hemiplegia contralaterally, involving primarily the lower limbs and pelvic floor musculature.
Unilateral contralateral motor weakness (leg/shoulder > arm/hand/face)
Minimal sensory changes (two-point discrimination) in the same distribution as above
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)
Grasp reflex and or sucking reflex contralaterally (if circle of Willis compromised)
Left limb apraxia