CNS Neurological Disorders & Diagnosis 2

Question 1

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

Accepted Answer

Non-contrast CT of the head

Answer

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

Question 2

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

Accepted Answer

Posterior superior temporal gyrus (Wernicke's area)

Answer

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

Question 3

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

Accepted Answer

Posterior inferior cerebellar artery

Answer

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

Question 4

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

Accepted Answer

4.5 hours

Answer

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

Question 5

Which presentation is most characteristic of aneurysmal subarachnoid hemorrhage?

Accepted Answer

Thunderclap headache described as the worst of one's life

Answer

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

CNS - Certified Neuro Specialist Practice Test