osteomed09
Forum Newbie
Topics: 5
Posts: 12
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A 55 y/o man is hospitalized after having a stroke. The MRI of the head is obtained 3 days later. The patient is most likely to have 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 limb and lower limbs
D. Weakness of the face, upper and lower limbs.
E. Weakness of the face and dysartria.
Please explain your answer. Thank you.
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| mamc
Forum Senior
Topics: 10
Posts: 27
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b
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| waqastariq
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for an MRI and CT scan... in my first year of med school ...I devised a flow chart for myself to identify the different structures...
for brain...
first see what section of brain it is...it is transverse section..
first look for bony structures.....bony structures are fine
then look for level of brain.... use BONY structures first and then go for soft tissue structures...its always better to look for bony things first... you can see here that the orbital plates of anterior cranial fossa are just appearin in this section...
now IMAGINE IMAGINE AND IMAGINE the brain present in cranial cavity....come back from the orbital plates....and see what part of the brain is involved in this infarction...
the infarction is the in the parietal lobe...on the lateral side...
the most COMMON SITE of cortical stroke....
typitally the patient presents with upper limb weekness and dysphasia and then progressive weekness of lower limb ....
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| waqastariq
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option B
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| waqastariq
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after three days..its APHASIA after such a "BIG" stroke..
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| DrVirgo
Forum Hero
Topics: 1096
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Its B.
I posted this q already. See the thread: NBME Stroke!
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| robin082006
Forum Hero
Topics: 471
Posts: 5,125
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yeah it is B, middle cebreral artery
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The Key to Succeed is Patience.
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| waqastariq
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dear friends...
I am new to this USMLE community and I plan to take step 1 next year around november/october as I am currently in final year and I cant study owing to the busy routine in our setup 
I plan to inshALLAH start for the step 1 from march 2007.
I dunno much about this NBME thingee except that it is a good predictor of your scores...
so does that mean that they repeat questions in NBME? and they arent different for every person?
it seems like that from DrVirgo's reply 
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| vamsi2004
Forum Elite
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can someone plz explain whether the lesion is present on rt or lt side of brain. im always confused with this...
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| Dr.Papez
Forum Senior
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Posts: 152
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the infarct is affecting the part of frontal and temporal lobes (perisylvian region) and very little if any of parietal lobe. Choice is B.
Conventionally most centers display the images with the right-left side as discussed in this section. Just imagine that the patient is standing right in front of you... his left is towards your right?? Confusing??
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| vamsi2004
Forum Elite
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ya its confusing.. in the fig plz tell whether the lesion is on right or left side..
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| Dr.Papez
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LEFT by convention
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| vamsi2004
Forum Elite
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thanku papez. in the ques its asked what signs on right? what is right and left for aphasia?
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| Dr.Papez
Forum Senior
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Well.. probably that was a clue that the lesion is on the left side (even if one doesnt know the side) .Of course there is no right or left aphasias.
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