Neurological Disorders & Diagnosis Flashcards

A patient arrives with sudden severe headache and left-sided weakness. Which imaging study should be performed first?

Answer: Non-contrast CT of the head

Non-contrast CT is fast and highly sensitive for acute hemorrhage, which must be excluded before thrombolysis.

A patient speaks fluently but with meaningless words and cannot understand commands. Where is the lesion most likely located?

Answer: Posterior superior temporal gyrus (Wernicke's area)

Wernicke's area damage causes fluent but nonsensical speech with impaired comprehension.

Ipsilateral facial pain/temperature loss, contralateral body pain/temperature loss, dysphagia, and ataxia suggest occlusion of which artery?

Answer: Posterior inferior cerebellar artery

Lateral medullary (Wallenberg) syndrome results from PICA or vertebral artery occlusion.

For eligible patients with acute ischemic stroke, IV alteplase may be given up to how long after last known well?

Answer: 4.5 hours

Guidelines support IV alteplase up to 4.5 hours from last known well in selected patients.

Which presentation is most characteristic of aneurysmal subarachnoid hemorrhage?

Answer: Thunderclap headache described as the worst of one's life

Aneurysmal SAH classically presents with a sudden, maximal-intensity thunderclap headache.

A pure motor hemiparesis affecting face, arm, and leg equally without cortical signs most likely results from a lacunar infarct in which location?

Answer: Posterior limb of the internal capsule

Corticospinal fibers converge in the posterior limb of the internal capsule, so a small lacune causes pure motor deficits.

What is the primary purpose of the NIH Stroke Scale?

Answer: To quantify stroke severity and track neurological deficits

The NIHSS is a standardized bedside tool that measures stroke severity and guides treatment decisions.