Point
1
Intro
As mentioned above, the term hemiplegia is commonly used by clinicians when discussing the effects of lesions of the corticospinal tract anywhere from the cortex to the medulla, and of the lateral corticospinal tract anywhere in the spinal cord. Cerebrovascular accidents commonly damage the corticospinal tract in the motor cortex or the posterior limb of the internal capsule (a compact bundle of axons through which almost all neural traffic to and from the cortex passes). The term "stroke" is poorly defined and has different meanings to different users. It generally implies the abrupt onset of neurological deficits as the result of cerebrovascular disease. As such, it includes the manifestations of cerebral hemorrhage (Gr. blood to burst forth; may be arterial, venus or capillary) cerebral infarction (L. to stuff into; area of tissue undergoes necrosis [death] following cessation of blood supply) and intracranial and extracranial thrombosis (Gr. clot condition; when a thrombus is detached from its original site and found in another site it is called a thrombotic embolis [Gr. embole=throwing in]).
As you have already learned, immediately following a lesion involving corticospinal or lateral corticospinal fibers, there is a period of flaccid paralysis (spinal shock). After a period of days to weeks, muscle tone (spasticity) and muscle reflexes return and increase. There will also be a Babinski sign, [extension of the big toe and fanning of the others in response to firmly stroking the sole of the foot].