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Old 10-22-2011
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Question Cns stroke q?

A 63-year-old woman with longstanding hypertension, diabetes, and hyperlipidemia was admitted to the Hospital, where she was noted to have vomiting, left-sided miosis, ptosis, and loss of facial pain and temperature sensation on the left, but loss of body sensation on the right and left-sided ataxia. A diffusion-weighted MRI and MRA are ordered. Before the radiologic studies are performed, the team asks the medical student where the problem lies. The best explanation for this patient's stroke presentation is occlusion of which of the following artery and loss of facial pain and temperature sensation is due to lesion in which part?

A. Left middle cerebral artery; involvement of vestibular nuclei
B. Left posterior inferior cerebellar artery; involvement of inferior cerebellar peduncle
C. Left anterior cerebral artery; involvement of lateral spinothalamic tract
D. Left posterior inferior cerebellar artery; involvement of spinal trigeminal nucleus and tract
E. Right posterior inferior cerebellar artery; involvement of spinal trigeminal nucleus and tract
F. Right posterior inferior cerebellar artery; involvement of inferior cerebellar peduncle
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c) left AICA; lateral spinothalamic tract
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c) left AICA; lateral spinothalamic tract
Wrong answer!!
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I was thinking between c and d, and choose c as D seemed bit low.
than D for sure.
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Old 10-22-2011
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Correct Answer

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Originally Posted by jahn77 View Post
I was thinking between c and d, and choose c as D seemed bit low.
than D for sure.
Yeaaaaa,
It is a case of Wallenberg syndrome involving PICA. becasue the facial involvement is on left and the body involvement is on right side, Left PICA should be affected. In this syndrome, the impaired facial temperature and pain sensation is due to spinal trigeminal nucleus and tract dysfunction.
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