[mtoi]

INPATIENT/ ER/ CLINIC/ OTHER - clinic
PATIENT PROFILE - 81 yo woman experienced 2nd stroke, after partial recovery she developed difficulty in producing and understanding speech
QUESTION - in what artery would the stroke causing thrombosis most likely be found?

A posterior communicating
B anterior circle of willis
C middle cerebral artery
D anterior communicating artery
E anterior cerebral artery

please discuss types of aphasias and blood supply of sites involved

 

[Pixie]

middle cerebral artery stroke.

 

[mtoi]

A posterior communicating - common area of aneurysm, oculomotor palsy
B anterior circle of willis - general sensory and motor dysfunction, and aphasia
àC middle cerebral artery - most common site of thrombosis
D anterior communicating artery - mc circle of willis aneurysm
E anterior cerebral artery - medial surface of brain, leg foot motor and sensory deficits

middle cerebral artery is most common site of thrombosis in stroke
Middle cerebralartery provides circulation to lateral aspect of brain including those regions involved in productionand comprehension of speech (broca's and wernicke's speech areas)

Aphasias
Broca's - FLUENCY impaired REPITITION OF SPOKEN LANGUAGE poor COMPREHENSION intact SITE OF LESION frontal lobe, inferior frontal gyrus (brodmann 44, 45)

Wernicke's - FLUENCY intact REPITITION OF SPOKEN LANGUAGE poor COMPREHENSION impaired SITE OF LESION posterior temporal lobe, superior temporal gyrus (brodmann 22)

Global - FLUENCY impaired REPITITION OF SPOKEN LANGUAGE poor COMPREHENSION impaired SITE OF LESION both broca and wernicke's areas affected

Conduction - FLUENCY intact REPITITION OF SPOKEN LANGUAGE poor COMPREHENSION intact SITE OF LESION arcuate fasciculus, interconnects broca and Wernicke areas

 

[rana tanveer]

MCA

MCA Occlusion leads to "MCA ABC"

Memory Impairment
Calculation Impairment
Aphasia
Apraxia
Blindness(contralateral Homonymous Hemianopsia)
Contralateral Clumsiness of Face and Arm (leg spared usually).....

So answer is MCA