QuestionSBA
QuestionChoice
The patient has had an infarction of his left middle cerebral artery which supplies the lateral aspect of the left hemisphere, and therefore Brocas (and Wernicke's) area which is responsible for language production and comprehension. An infarct to this area would result in an expressive aphasia characterised by partial loss of the ability to produce spoken and written language. They may lose their ability to comprehend speech if Wernicke's area is also affected, and would exhibit an increased work of speech.
10006906
a
Expressive aphasia
QuestionChoice
Motor control of the lower limbs is principally controlled by the medial aspect of the brain (outlined by the motor homunculus). The lower limbs are therefore more likely to be affected by an anterior cerebral artery infarct, whereas a middle cerebral artery infarct would affect the upper limbs more than the lower limbs.
10006907
b
Right-sided lower limb weakness
QuestionChoice
A bitemporal hemianopia represents a loss in the peripheral visual field bilaterally. This may be caused by a stroke in rare circumstances, but is more commonly seen following the enlargement of a pituitary mass which presses on the optic chiasm.
10006908
c
Bitemporal hemianopia
QuestionChoice
A middle cerebral artery infarction can result in a one-sided hemiplegia (affecting arms more than legs). However, this patient suffered a left-sided infarct, which would cause motor symptoms on the contralateral (right) side, making this answer incorrect.
10006909
d
Left-sided hemiplegia
QuestionChoice
Dysdiadochokinesia is a sign of impaired coordination, typically due to cerebellar damage. It would not be seen as a result of a middle cerebral artery infarct.
10006910
e
Dysdiadochokinesia
Concept
Chapter
2693
3743
Ischaemic Stroke
Topic
141
Neurology
13928
A 78-year-old male presents following a stroke. Imaging reveals a left middle cerebral artery infarct.

Which of the following presenting features is most in line with the imaging findings?
a