Neurologists Exam Cerebrovascular Disease & Stroke 2

Question 1

Which neuroimaging modality has the highest sensitivity for detecting acute ischemic stroke within the first 6 hours of onset?

Accepted Answer

MRI diffusion-weighted imaging (DWI)

Answer

Non-contrast CT scan

Answer

CT perfusion with contrast

Answer

Conventional cerebral angiography

Question 2

On non-contrast CT, acute intraparenchymal hemorrhage appears as:

Accepted Answer

A hyperdense (bright) region

Answer

A hypodense (dark) region

Answer

An isodense region indistinguishable from normal brain

Answer

A ring-enhancing lesion

Question 3

The 'hyperdense MCA sign' on non-contrast CT in acute stroke represents:

Accepted Answer

Acute thrombus within the middle cerebral artery lumen

Answer

Early cytotoxic edema in MCA territory

Answer

Calcification of the MCA wall

Answer

Contrast enhancement from blood-brain barrier breakdown

Question 4

In acute stroke perfusion imaging, the 'penumbra' is defined as:

Accepted Answer

The ischemic but potentially salvageable tissue surrounding the infarct core

Answer

The irreversibly infarcted core with absent perfusion

Answer

The area of luxury perfusion after successful reperfusion

Answer

The zone of cortical spreading depolarization adjacent to the infarct

Question 5

Which cardiac condition is the most common identifiable cause of cardioembolic stroke?

Accepted Answer

Atrial fibrillation

Answer

Mitral stenosis with rheumatic heart disease

Answer

Patent foramen ovale

Answer

Dilated cardiomyopathy with reduced EF

Question 6

A patient presents with sudden onset 'thunderclap' headache described as 'the worst headache of my life.' What is the most urgent diagnosis to exclude?

Accepted Answer

Subarachnoid hemorrhage (SAH)

Answer

Complicated migraine with aura

Answer

Hypertensive urgency headache

Answer

Cerebral venous sinus thrombosis

Question 7

The ABCD2 score after a transient ischemic attack (TIA) is used to:

Accepted Answer

Stratify short-term risk of subsequent stroke to guide urgency of workup

Answer

Determine eligibility for IV thrombolysis

Answer

Score disability at hospital discharge

Answer

Classify stroke etiology by mechanism