In 1906, Spanish otorhinolaryngologist Antonio Garcia Tapia became the first to describe a lesion of the vagus and hypoglossal nerves with contralateral hemiplegia
. (1) Tapia's original patient was a matador who had sustained a wound to the neck from a bull's horn.
In complete occlusion symptoms include contralateral gaze palsy, hemiplegia, hemisensory loss, spatial neglect and homonymous hemianopia.[4,8] Global aphasia is present with left hemisphere lesions. Occlusion of the superior trunk of the middle cerebral artery will result in the following symptoms: contralateral hemiplegia and hemianesthesia in the face and arm with lesser involvement of the lower extremity, ipsilateral deviation of eyes and head, and Broca's aphasia (with dominant hemisphere occlusion).[4,8] Occlusion of the inferior trunk of the middle cerebral artery usually results in contralateral hemianopsia or upper quadrantanopia, Wernicke's aphasia (usually with left sided lesions) and left visual neglect (usually with right sided lesions).
The anterior choroidal artery (Table 1) is responsible for supplying blood to deep structures of the brain including the globus pallidus (basal ganglia), lateral geniculate body (thalamus), posterior limb of the internal capsule and medial temporal lobe.[8,17] Occlusion of the anterior choroidal artery results in contralateral hemiplegia, hemihypesthesia and homonymous hemianopia.