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  #1  
Old 10-02-2012
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Arrow Belindalimm Daily Questions: Pathology #18

A 70-year-old, right-handed woman comes to the emergency department because of acute loss of vision in the right visual field. She denies headache, slurred speech, difficulty swallowing, weakness, numbness, and difficulty walking. Her other medical problems include hypertension, atrial fibrillation, and hyperlipidemia. Her blood pressure is 170/102mmHg and pulse is 90/min and irregular. Neurologic examination shows that she is awake, alert, and oriented. Her speech is fluent, and she follows complex commands. Examination shows a right homonymous hemianopsia. The rest of the neurologic examination is within normal limits. Which of the following cerebral vascular territories is most likely to have been compromised to cause the abnormality seen in this patient?

A. Anterior cerebral artery
B. Anterior choroidal artery
C. Artery of Percheron
D. Basilar artery
E. Middle cerebral artery
F. Posterior cerebral artery
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  #2  
Old 10-02-2012
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F. Posterior cerebral artery
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  #3  
Old 10-02-2012
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?BB...isolated optic tract lesion
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  #4  
Old 10-02-2012
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Default my answer :)

F. Posterior cerebral artery
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Old 10-02-2012
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F) pca ???
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Old 10-02-2012
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Might be F
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Old 10-02-2012
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Default B. Anterior choroidal artery

right homonymous hemianopsia
That means- there is left optic tract defect.
Confused between B and F
but i think to be Posterior cerebral artery. There will be hemianopsia with maccular sparing. but not sure
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Old 10-03-2012
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?post.cerebral a
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Old 12-17-2012
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Default pca

pca should be the answer bcz it might take some time for macular sparing to occur
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Old 12-17-2012
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i think middle cerebral artery as pca will be showing macular sparing
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Old 12-17-2012
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Hm between B and F.

Anterior choroidal feeds lateral geniculate which if lesioned can cause right homonymous hemianopsia as well. But i thought it usually would be seen with other problems as well like hemiplegia, yet other test came out normal.

So ill go with F.
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Old 12-21-2012
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post cerebral artery
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Old 12-22-2012
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Ya left PCA involved
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Old 12-23-2012
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What about ACA, since berry aneurysms form at the bifurcation of AComm from the ACA. That can inpinge on optic tract. PCA will have macular sparing. Correct me if I am wrong pls...
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Old 01-13-2013
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Aca impinging on optic tract.. ??. ( sounds weird to me)..But here no headache( berry aneurysm from aca produce thunderclap headache)..
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  #16  
Old 01-13-2013
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Its anterior choroidal artery. Its a homonymous hemianopsia, no mention of macular sparing, hence occipital lobe ruled out, must be involving the optic tract, supplied by ant choroidal artery.
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  #17  
Old 01-13-2013
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Quote:
Originally Posted by belindalimm View Post
A 70-year-old, right-handed woman comes to the emergency department because of acute loss of vision in the right visual field. She denies headache, slurred speech, difficulty swallowing, weakness, numbness, and difficulty walking. Her other medical problems include hypertension, atrial fibrillation, and hyperlipidemia. Her blood pressure is 170/102mmHg and pulse is 90/min and irregular. Neurologic examination shows that she is awake, alert, and oriented. Her speech is fluent, and she follows complex commands. Examination shows a right homonymous hemianopsia. The rest of the neurologic examination is within normal limits. Which of the following cerebral vascular territories is most likely to have been compromised to cause the abnormality seen in this patient?

A. Anterior cerebral artery
B. Anterior choroidal artery
C. Artery of Percheron
D. Basilar artery
E. Middle cerebral artery
F. Posterior cerebral artery



Posterior cerebral artery
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  #18  
Old 01-25-2013
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yeah I'm going with B) Anterior choroidal artery
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