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Stroke Syndromes Imaging 01

Topic: Imaging

Created on Sunday, March 18 2007 by jdmiles

Last modified on Saturday, September 22 2007.

One day after after the onset of this patient's stroke symptoms, the above FLAIR MRI image was taken. Of the following choices, which syndrome is most likely to be found in this patient?


 
        A) Balint's syndrome
 
        B) Wernicke's aphasia
 
        C) Broca's aphasia
 
        D) Left homonymous hemianopsia
 
        E) Alexia without agraphia
 

 


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This question was created on March 18, 2007 by jdmiles.
This question was last modified on September 22, 2007.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Balint's syndrome

This answer is incorrect.


Balint's syndrome (psychic paralysis of gaze, ocular apraxia, and visual innatention with normal viusal fields) results from damage to bilateral parietal-occipital areas.  (See References)

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B) Wernicke's aphasia

This answer is incorrect.


Wernicke's aphasia typically localizes to the dominant angular and supramarinal gyri of the temporal lobe. The temporal lobe is not involved in this patient's stroke.  (See References)

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C) Broca's aphasia

This answer is incorrect.


Broca's aphasia typically localizes to the dominant frontal suprasylvian area. The frontal lobe is not affected in this patient's stroke.  (See References)

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D) left homonymous hemianopsia

This answer is incorrect.


This patient has had a stroke in the left occipital cortex, resulting in a right homonymous hemianopsia.  (See References)

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E) alexia without agraphia

This answer is correct.


This patient has had a stroke in the left occipital cortex, resulting in a right homonymous hemianopsia. The stroke extends rostrally, resulting in damage to the callosal fibers decussating from the right occipital cortex. As a result, this patient will be unable to read anything presented in either visual field (alexia). However, language areas are not directly affected, so the ability to write is preserved (no agraphia).  (See References)

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References:

1. Victor, M., and Ropper, A.H. (2001). Adams and Victor's Principles of Neurology, 7th Edition. McGraw-Hill, New York.
2. Bradley, W.G., Daroff, R.B., Fenichel, G.M., and Jankovic, J. (Eds.) (2004). Neurology in Clinical Practice, 4th Edition. Butterworth Heinemann, Philadelphia.
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imaging
Stroke Syndromes Imaging 01
Question ID: 31907089
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 03/18/2007
Modified: 09/22/2007
Estimated Permutations: 8400

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