Neuropathological Conditions and Clinical Presentations Flashcards
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According to standard classification criteria, a traumatic brain injury is classified as 'severe' when the post-resuscitation Glasgow Coma Scale score is:
Answer: 3–8
Severe TBI is defined by a GCS score of 3–8, reflecting profound impairment of consciousness at the time of injury.
Following mild traumatic brain injury (concussion), which neuropsychological domain demonstrates the most consistent acute-phase impairment?
Answer: Processing speed and sustained attention
Processing speed and attention are the most reliably impaired cognitive domains in the acute and subacute phases after mild TBI, reflecting disrupted neural efficiency.
Post-stroke aphasia characterized by non-fluent speech output, impaired repetition, and relatively preserved auditory comprehension is most consistent with which syndrome?
Answer: Broca's aphasia
Broca's aphasia involves non-fluent, effortful output with impaired repetition and relatively preserved comprehension due to lesions in the left posterior inferior frontal gyrus.
A patient with left temporal lobe epilepsy is most likely to demonstrate which selective memory impairment on neuropsychological testing?
Answer: Impaired verbal learning and recall with relatively preserved visuospatial memory
Left temporal lobe epilepsy disrupts the language-dominant hippocampus and surrounding cortex, producing selective verbal memory deficits while visuospatial memory, subserved by the right hemisphere, remains relatively intact.
Which neuropsychological measure is considered most sensitive for detecting left hippocampal dysfunction in temporal lobe epilepsy presurgical evaluation?
Answer: California Verbal Learning Test (CVLT) delayed recall
Verbal list-learning measures such as the CVLT are highly sensitive to left hippocampal dysfunction because they tax the encoding and consolidation processes dependent on left medial temporal structures.
A patient sustains a right hemisphere ischemic stroke. Which constellation of deficits is most expected on neuropsychological examination?
Answer: Left hemispatial neglect, constructional apraxia, and left hemiplegia
Right hemisphere strokes commonly produce left hemispatial neglect, impaired constructional abilities, and left-sided motor and sensory deficits rather than aphasia.
The Wada test (intracarotid sodium amobarbital procedure) is administered during epilepsy surgery evaluation primarily to determine:
Answer: Language lateralization and adequacy of contralateral memory
The Wada test temporarily inactivates one hemisphere to establish language dominance lateralization and to assess whether the contralateral hemisphere can support memory after resection.