ssrpk
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A 49 year old male patient is brought to the emergency room by his wife because he has difficulty raising his right arm. He is able to make a fist with his right hand and hold objects with no weakness. He complains of numbness on the right side of his trunk and thigh, and he has some weakness of the anterior thigh muscles. A left sided carotid bruit is present
The patient's signs and symptoms may have resulted from :
a) bleeding from an AVM
b) a subarachnoid hemorrhage
c) a water-shed infarct in the MCA-ACA territory
d) a lacunar stroke
e) an embolus in the MCA
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| cyra
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hmm...can't decide between c and d.
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| ssrpk
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well u did a nice job in excluding the rest,
think through it, if it were lacunar stroke, which most iof the time involves smaller areas, like basal ganglia or internal capsule, the manifestations would hv been widespread, commonly the whole contralateral side.
however, in the the surface lesions, as in this case, due to infarcts in the water-shed areas are more localized. [ischemia due to stenosis of int.carotid artery --> bruit]
correct answer is c
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| cyra
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Thankyou for the explaination...its a lot clearer now!
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| sethigulshan
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good question
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