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Cause of Tissue Damage
Ischemic
What Is a Watershed Stroke?
Hemorrhagic
Bleeding of a blood vessel in the brain causes ahemorrhagic stroke. This often happens when arteries in the brain stiffen and break with high blood pressure.
Location
Cortical Stroke
Acortical strokeaffects the cerebral cortex, which is important for higher cognitive functions. It also contains areas that are responsible for processing sensory information and controlling voluntary movement. Depending on the location of the cortical stroke, symptoms may include problems with speech, loss of vision in half of the visual field, spatial neglect, and one-sided muscle weakness.
Frontal Cortex
Afrontal lobe strokeoften causes muscle weakness on the opposite side of the body and trouble with decision-making. People with a stroke involving the frontal cortex may also experienceaphasiaand display socially inappropriate behavior, apathy, or impulsiveness. Occasionally, loss of bladder or bowel control may result.
Parietal Cortex
The parietal cortex is involved with integration of sensation and language. People with aparietal strokeoften display impaired sensation or trouble with theproduction of speech.
Occipital Cortex
The occipital cortex integrates vision. Astroke in the occipital lobemay cause complete or partial loss of vision on the opposite side of the occipital region affected.
Temporal Cortex
The temporal cortex is involved with hearing and language. People who have had atemporal lobe strokeoften have troubleunderstanding written or spoken language.
Subcortical
A subcortical stroke, also known assmall vessels stoke, affects the deeper regions of the brain. This includes structures like the basal ganglia, internal capsule, and subcortical loops connecting the cortex.
A stroke affecting the basal ganglia can result in problems with language and speech. A stroke affecting the internal capsule may affect motor or sensory function of one or more parts of the opposite side of the body.
Thalamic
A thalamic stroke usually causes significant sensory deficits on the opposite side of one or more parts of the body, even when the stroke affects a relatively small region of the brain.
Brainstem
Abrainstem strokecan cause a wide variety of signs and symptoms. It may cause weakness, sensory changes, or trouble speaking. A brainstem stroke can affect the movement of the opposite side or the same side of the face or mouth. People who experience a brainstem stroke may have trouble with eye movements, which often manifests as double vision or blurred vision. Additionally, the brainstem controls breathing and regulates the heart rate. A brainstem stroke may affect vital functions, even when a relatively small area is affected.
Blood Vessel
Some strokes are named after the blood vessel that was blocked or bleeding. The most commonly identified blood vessel in a stroke is themiddle cerebral artery, which often causes a large cortical stroke affecting the temporaland parietal lobes.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.About stroke,American Stroke Association.Ischemic stroke (clots).Weill C, Suissa L, Darcourt J, Mahagne MH.The pathophysiology of watershed infarction: a three-dimensional time-of-flight magnetic resonance angiography study.J Stroke Cerebrovasc Dis. 2017;26(9):1966-1973. doi:10.1016/j.jstrokecerebrovasdis.2017.06.016Yale Medicine.Hemorrhagic stroke.American Stroke Association.Hemorrhagic stroke (bleeds).Hoglund J, Strong D, Rhoten J, et al.Test characteristics of a 5‐element cortical screen for identifying anterior circulation large vessel occlusion ischemic strokes.JACEP Open. 2020;1(5):908-917. doi:10.1002/emp2.12188Krudop WA, Pijnenburg YAL.Historical evolution of the frontal lobe syndrome.Psychopathology. 2015;48(4):222-229. doi:10.1159/000381986Grossman M, Irwin DJ.Primary progressive aphasia and stroke aphasia.Continuum (Minneap Minn). 2018;24(3):745-767. doi:10.1212/CON.0000000000000618Pula JH, Yuen CA.Eyes and stroke: the visual aspects of cerebrovascular disease.Stroke Vasc Neurol. 2017;2(4):210-220. doi:10.1136/svn-2017-000079Lee KB, Kim JS, Hong BY, et al.Brain lesions affecting gait recovery in stroke patients.Brain Behav. 2017;7(11):e00868. doi:10.1002/brb3.868Gupta N, Pandey S.Post-thalamic stroke movement disorders: a systematic review.Eur Neurol. 2018;79(5-6):303-314. doi:10.1159/000490070American Stroke Association.Brain stem stroke.Weaver NA, Kancheva AK, Lim JS, et al.Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts.Int J Stroke. 2021;16(8):981-989. doi:10.1177/1747493020984552
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.About stroke,American Stroke Association.Ischemic stroke (clots).Weill C, Suissa L, Darcourt J, Mahagne MH.The pathophysiology of watershed infarction: a three-dimensional time-of-flight magnetic resonance angiography study.J Stroke Cerebrovasc Dis. 2017;26(9):1966-1973. doi:10.1016/j.jstrokecerebrovasdis.2017.06.016Yale Medicine.Hemorrhagic stroke.American Stroke Association.Hemorrhagic stroke (bleeds).Hoglund J, Strong D, Rhoten J, et al.Test characteristics of a 5‐element cortical screen for identifying anterior circulation large vessel occlusion ischemic strokes.JACEP Open. 2020;1(5):908-917. doi:10.1002/emp2.12188Krudop WA, Pijnenburg YAL.Historical evolution of the frontal lobe syndrome.Psychopathology. 2015;48(4):222-229. doi:10.1159/000381986Grossman M, Irwin DJ.Primary progressive aphasia and stroke aphasia.Continuum (Minneap Minn). 2018;24(3):745-767. doi:10.1212/CON.0000000000000618Pula JH, Yuen CA.Eyes and stroke: the visual aspects of cerebrovascular disease.Stroke Vasc Neurol. 2017;2(4):210-220. doi:10.1136/svn-2017-000079Lee KB, Kim JS, Hong BY, et al.Brain lesions affecting gait recovery in stroke patients.Brain Behav. 2017;7(11):e00868. doi:10.1002/brb3.868Gupta N, Pandey S.Post-thalamic stroke movement disorders: a systematic review.Eur Neurol. 2018;79(5-6):303-314. doi:10.1159/000490070American Stroke Association.Brain stem stroke.Weaver NA, Kancheva AK, Lim JS, et al.Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts.Int J Stroke. 2021;16(8):981-989. doi:10.1177/1747493020984552
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.About stroke,American Stroke Association.Ischemic stroke (clots).Weill C, Suissa L, Darcourt J, Mahagne MH.The pathophysiology of watershed infarction: a three-dimensional time-of-flight magnetic resonance angiography study.J Stroke Cerebrovasc Dis. 2017;26(9):1966-1973. doi:10.1016/j.jstrokecerebrovasdis.2017.06.016Yale Medicine.Hemorrhagic stroke.American Stroke Association.Hemorrhagic stroke (bleeds).Hoglund J, Strong D, Rhoten J, et al.Test characteristics of a 5‐element cortical screen for identifying anterior circulation large vessel occlusion ischemic strokes.JACEP Open. 2020;1(5):908-917. doi:10.1002/emp2.12188Krudop WA, Pijnenburg YAL.Historical evolution of the frontal lobe syndrome.Psychopathology. 2015;48(4):222-229. doi:10.1159/000381986Grossman M, Irwin DJ.Primary progressive aphasia and stroke aphasia.Continuum (Minneap Minn). 2018;24(3):745-767. doi:10.1212/CON.0000000000000618Pula JH, Yuen CA.Eyes and stroke: the visual aspects of cerebrovascular disease.Stroke Vasc Neurol. 2017;2(4):210-220. doi:10.1136/svn-2017-000079Lee KB, Kim JS, Hong BY, et al.Brain lesions affecting gait recovery in stroke patients.Brain Behav. 2017;7(11):e00868. doi:10.1002/brb3.868Gupta N, Pandey S.Post-thalamic stroke movement disorders: a systematic review.Eur Neurol. 2018;79(5-6):303-314. doi:10.1159/000490070American Stroke Association.Brain stem stroke.Weaver NA, Kancheva AK, Lim JS, et al.Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts.Int J Stroke. 2021;16(8):981-989. doi:10.1177/1747493020984552
Centers for Disease Control and Prevention.About stroke,
American Stroke Association.Ischemic stroke (clots).
Weill C, Suissa L, Darcourt J, Mahagne MH.The pathophysiology of watershed infarction: a three-dimensional time-of-flight magnetic resonance angiography study.J Stroke Cerebrovasc Dis. 2017;26(9):1966-1973. doi:10.1016/j.jstrokecerebrovasdis.2017.06.016
Yale Medicine.Hemorrhagic stroke.
American Stroke Association.Hemorrhagic stroke (bleeds).
Hoglund J, Strong D, Rhoten J, et al.Test characteristics of a 5‐element cortical screen for identifying anterior circulation large vessel occlusion ischemic strokes.JACEP Open. 2020;1(5):908-917. doi:10.1002/emp2.12188
Krudop WA, Pijnenburg YAL.Historical evolution of the frontal lobe syndrome.Psychopathology. 2015;48(4):222-229. doi:10.1159/000381986
Grossman M, Irwin DJ.Primary progressive aphasia and stroke aphasia.Continuum (Minneap Minn). 2018;24(3):745-767. doi:10.1212/CON.0000000000000618
Pula JH, Yuen CA.Eyes and stroke: the visual aspects of cerebrovascular disease.Stroke Vasc Neurol. 2017;2(4):210-220. doi:10.1136/svn-2017-000079
Lee KB, Kim JS, Hong BY, et al.Brain lesions affecting gait recovery in stroke patients.Brain Behav. 2017;7(11):e00868. doi:10.1002/brb3.868
Gupta N, Pandey S.Post-thalamic stroke movement disorders: a systematic review.Eur Neurol. 2018;79(5-6):303-314. doi:10.1159/000490070
American Stroke Association.Brain stem stroke.
Weaver NA, Kancheva AK, Lim JS, et al.Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts.Int J Stroke. 2021;16(8):981-989. doi:10.1177/1747493020984552
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