AANN Comprehensive Review for Stroke Nursing, 2nd Edition, Ch. 1 Anatomy and Physiology: Digital Version-Stroke Chapter 1

Stroke Chapter 1

Pdf Summary

This chapter reviews the neuroanatomy and pathophysiology needed to recognize, localize, and guide care for stroke. Brain regions have specialized functions: the cerebral lobes support movement, sensation, language, vision, and behavior; the cerebellum coordinates movement and balance; and the brain stem controls basic functions and contains important cranial nerve pathways. Injury location therefore shapes neurologic symptoms.<br /><br />The carotid arteries supply the anterior circulation, while the vertebral and basilar arteries supply the posterior circulation. Major vessel syndromes help connect symptoms to lesion sites. Middle cerebral artery (MCA) strokes commonly cause contralateral face and arm weakness, sensory loss, and—depending on hemisphere—aphasia or neglect. Anterior cerebral artery strokes tend to affect the opposite leg more than the arm. Posterior cerebral artery strokes often impair vision. Posterior circulation strokes may cause vertigo, ataxia, cranial nerve signs, dysphagia, or altered consciousness; examples include Wallenberg’s syndrome from posterior inferior cerebellar artery involvement and potentially life-threatening basilar artery occlusion.<br /><br />In ischemic stroke, reduced blood flow creates an infarct core and surrounding penumbra: tissue that is impaired but potentially salvageable if perfusion is restored. Hemorrhagic stroke damages brain tissue through hematoma pressure and subsequent cellular injury, inflammation, and edema. Subarachnoid hemorrhage may also cause early brain injury and delayed vasospasm.<br /><br />The chapter also describes lacunar and watershed strokes, cerebral venous thrombosis, and stroke mimics such as hypoglycemia, seizures, migraine, and neurologic disorders. Careful assessment and imaging are essential because mimics can resemble stroke, and symptoms may not follow a vascular territory.<br /><br />Neuroplasticity—through neural sprouting and functional reorganization—supports recovery and underlies rehabilitation. Its effects vary with individual factors and therapy; optimal rehabilitation timing and intensity remain uncertain. Overall, linking examination findings to anatomy and vascular supply supports timely diagnosis, treatment, and individualized rehabilitation.

Keywords

stroke neuroanatomy

pathophysiology

cerebral circulation

middle cerebral artery

anterior cerebral artery

posterior cerebral artery

ischemic stroke

hemorrhagic stroke

stroke mimics

neuroplasticity