Border zone anterior circulation syndromes

Bilateral lesions (rare)

These lesions may mimic spinal or medullary lesions.


  • Quadriplegia with or without sensory deficit
  • Bilateral brachial paresis with or without sensory deficit (Man-in-a-barrel syndrome)
  • Paraplegia with or without sensory deficit
  • Impaired bladder function
  • Focal myoclonus

Precentral lesions

  • Crural monoparesis with or without sensory deficit
  • Brachial monoparesis with or without sensory deficit
  • Hemiparesis sparing the face, with or without sensory deficit
  • Transcortical aphasia
  • Focal myoclonus
  • Akinetic mutism
  • Apathy

Postcentral lesions

  • Cortical type hemihypesthesia
  • Sensorimotor hemiparesis, often sparing the face
  • Hemisensory neglect
  • Anosognosia
  • Lower quadrant quadrantanopia or hemianopia
  • Visual hemineglect
  • Wernicke’s aphasia
  • Transcortical aphasia
  • Focal myoclonus