UMEM Educational Pearls

Category: Neurology

Title: cortical vs. subcortical strokes

Posted: 1/6/2010 by Aisha Liferidge, MD (Updated: 4/26/2024)
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Cortical versus Subcortical Strokes

Gray matter (neuronal cell bodies) of the brain forms a rim over the cerebral hemispheres, forming the cerebral cortex.
White matter (neuronal axons coated in myelin) is located below the cortex and makes up the "subcortical" regions of the brain.
Strokes affecting the cerebral cortex (i.e. cortical strokes) classically present with deficits such as neglect, aphasia, and hemianopia.
Subcortical strokes affect the small vessels deep in the brain, and typically present with purely motor hemiparesis affecting the face, arm, and leg.
Nearly 30% of all ischemic strokes are subcortical in nature, and includes lacunar infarcts which have the best prognosis.

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Aisha T. Liferidge, MD, FACEP
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Assistant Professor, Attending Physician
University of Maryland School of Medicine
Department of Emergency Medicine
Baltimore, MD 21201
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MPH Candidate, Columbia University 2011