ASC Neurological Assessment & Monitoring 2

Question 1

A patient with a right MCA stroke presents with left-sided neglect. Which assessment tool best quantifies this deficit?

Accepted Answer

Catherine Bergego Scale

Answer

The Catherine Bergego Scale (CBS) is specifically validated to assess unilateral neglect in functional activities after stroke.

Question 2

When performing serial NIH Stroke Scale assessments, a 4-point worsening is considered clinically significant because it indicates:

Accepted Answer

Early neurological deterioration requiring intervention

Answer

A ≥4-point increase in NIHSS score defines early neurological deterioration (END), which triggers urgent reassessment and intervention.

Question 3

A patient's pupils are 3mm bilaterally and reactive. Six hours later they are 6mm and sluggish on the left. This change most likely indicates:

Accepted Answer

Uncal herniation compressing CN III

Answer

Unilateral pupil dilation with sluggish reactivity is a classic sign of uncal herniation compressing the ipsilateral oculomotor nerve (CN III).

Question 4

Which finding on continuous EEG monitoring in a post-stroke patient indicates subclinical seizure activity requiring treatment?

Accepted Answer

Periodic lateralized epileptiform discharges (PLEDs) evolving into rhythmic ictal pattern

Answer

PLEDs that evolve into a rhythmic ictal pattern on cEEG represent non-convulsive seizures requiring antiepileptic intervention.

Question 5

The 'locked-in syndrome' following basilar artery occlusion is best distinguished from coma by the presence of:

Accepted Answer

Preserved vertical eye movements and blinking

Answer

Locked-in syndrome spares the dorsal midbrain, preserving vertical gaze and volitional blinking as the only motor output.

(ASC) Advanced Stroke Coordinator Certification Practice Test