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Table 65.5

Some Atypical Presentations of Stroke

Site of strokeClinical features
BrainstemIsolated cranial nerve disorders, vertigo, crossed motor and sensory signs, ataxia
Frontal lobeChange in behaviour/personality without focal neurological signs
Localized language areaMobile aphasic patient often initially diagnosed as delirium/dementia
Bilateral thalamic infarctionConfusion
PonsLocked in syndrome
Cortical lesionsFocal seizures
Basal gangliaAbnormal movements, for example asterixis, hemifacial spasms
Visual cortexIsolated visual symptoms, for example Anton's syndrome, Balint's syndrome
Frontal or posterolateral parietal lobeAlien hand syndrome