Believe
Forum Senior
Topics: 36
Posts: 93
|
A 55-year-old man is hospitalized after having a stroke. The MRI of the head is obtained 3 days later. The patient most likely has which of the following signs on the right?
A) Homonymous hemianopia and numbness of the face
B) Weakness of the upper limb and aphasia
C) Weakness of the upper and lower limbs
D) Weakness of the face, upper and lower limbs
E) Weakness of the face and dysarthria
___________________
Focus on the one step you can take right now. Let go all regrets and resentment about what has already happened.
|
| reet
Forum Fanatic
Topics: 152
Posts: 1,411
|
E ???
___________________
Live as u were to die tommorow. Learn as if u were to live forever.
|
| reet
Forum Fanatic
Topics: 152
Posts: 1,411
|
 no more reply??
___________________
Live as u were to die tommorow. Learn as if u were to live forever.
|
| asianroomie
Forum Newbie
Topics: 1
Posts: 9
|
B???????????????//
|
| DrMary
Forum Elite
Topics: 30
Posts: 98
|
B or E...not sure which one...
|
| drk1980
Forum Guru
Topics: 147
Posts: 1,038
|
is it a block in a branch of MCA?
|
| sturge_weber
Forum Guru
Topics: 77
Posts: 1,042
|
its the lateral side ogf the head, has to be the middle cerebral art. i too think e
|
| msyamp
Forum Fanatic
Topics: 60
Posts: 1,462
|
i think it is e
it is middle cerebral artery
___________________
If you think you can You can! If you think you cant you are right again!!
|
| Natasa
Forum Elite
Topics: 9
Posts: 291
|
I think it is B????
|
| drk1980
Forum Guru
Topics: 147
Posts: 1,038
|
why not A?
|
| msyamp
Forum Fanatic
Topics: 60
Posts: 1,462
|
plase give explainatinos and answers. FAAAAAST
___________________
If you think you can You can! If you think you cant you are right again!!
|
| Natasa
Forum Elite
Topics: 9
Posts: 291
|
a) Homonymous hemianopia and numbness of the face
B) Weakness of the upper limb and aphasia
C) Weakness of the upper and lower limbs
D) Weakness of the face, upper and lower limbs
E) Weakness of the face and dysarthria
OK,Why I think it is B?First of all,from MRI it is quite clear that the artery in question is left MCA.According to Blueprints in neurology,Left hemisphere lesions are mainly due to occlusion if either left internal carotid or left MCA.Clinical symptoms include:Right sided weakness snd sensory loss,right visual field defect,inability to gaze to the right and aphasia.The patient could also have impairment of reading,writing and calculation.If the lesion is isolated to the ACA(anterior cerebral artery) your main finding will be right leg weakness.
In A you have numbness in face and homonymous hemianopsia on the right.To me,it is highly unlikely that,with a stroke in MCA you would have isolated sensory deficit and only in face(for hemianopsia,it could be).That would look more like PCA(posterior cerebral artery) deficit.(if thalamus is involved amongst other structures).But then,it should go with alexia without agraphia,difficulty naming colors when presented visually etc.(if corpus callosum is involved).
C is pointing out to ACA as well(leg weakness),and weall,I guess, agree that in this MRI it is not the case.For the same reason,I would not go with D.
For E-Dysarthria and weakness of the face:It is pointing out to the lesion somewhere in pons/medulla and to the nucleuses of VII ,maybe X and IX cranial nerves,or even XII(possibly a peripheral facialis as well)-which are in the brainstem.And,That should be vertebrobasilary circulation,not the MCA teritory.
I agree that the question is not an easy one,especially because they give you only few symptoms and there is a lot of guessing to be done.
Hopefully,someone else will post their explanations,as I am not sure that the above is 100 % correct.
But,I would go with a B option on an exam.
Edited by Natasa on 12/12/05 - 03:03 AM. Reason: more detailes
|
| hellohie
Forum Junior
Topics: 1
Posts: 38
|
I AGREE WITH NATASA.
|
| Cedrick
Forum Fanatic
Topics: 320
Posts: 1,932
|
B.-weakeness of upper limb and aphasia
as I learn
|
| waqastariq
|
B
|
| Musuq
Forum Guru
Topics: 103
Posts: 425
|
B
MCA compromise
contralat spastic paralysis and anesthesia of upper limb/face , Gaze palsy, aphasia
|
| ManuNastai
Transilvanian..
Topics: 55
Posts: 838
|
E
___________________
"Love is the only inflamation of the heart that drains in the vagina" (translation after Dr Petre Florescu, Professor of Pathology, UMF "Iuliu Hatieganu", Cluj Napoca
|
| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,819
|
agree with B as natasa explained!
dysarthria would occur with peripheral nerve lesions or with cerebellar lesions! in cortical lesions aphasia is more likely!
although realize one thing that dysarthria may be associated with aphasia but dysarthria alone doesn't constitute aphasia!
___________________
life is guud
|
| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,819
|
and also in this instance motor weakness will be present in the lower half of the face!
___________________
life is guud
|
| Ig F
Forum Elite
Topics: 3
Posts: 436
|
its B as it has involved MCA....
___________________
i m not perfect but i wanna get close to it......
|
| Dr.Papez
Forum Senior
Topics: 0
Posts: 152
|
Answer is B. Natasa's explantion is right.
By convention in majority of centers (rather in almost all centers with regard to MRI) the affected side on the MRI is left side-since it involves perisylvian area it is likely to produce dysphasia-motor>sensory and right face/upper limb weakness.
Papez
|
|
| |
| | | | | | | | | | | | | | | | | | | | | |
