Neurologists Exam Cerebrovascular Disease & Stroke

Question 1

What percentage of all strokes are classified as ischemic strokes?

Accepted Answer

Approximately 87%

Answer

Ischemic strokes account for approximately 87% of all strokes, making them by far the most common type.

Question 2

Which small penetrating arteries are most commonly involved in lacunar infarcts affecting the basal ganglia and internal capsule?

Accepted Answer

Lenticulostriate arteries

Answer

Lenticulostriate arteries are small penetrating branches of the MCA that supply the basal ganglia and internal capsule, making them the primary vessels involved in lacunar infarcts at these sites.

Question 3

A patient presents with sudden right-sided face and arm weakness, expressive aphasia, and left gaze preference. Which arterial territory is most likely occluded?

Accepted Answer

Left middle cerebral artery

Answer

Left MCA territory strokes cause contralateral (right-sided) hemiparesis, Broca's or global aphasia, and ipsilateral gaze preference (eyes deviate toward the lesion side).

Question 4

What is the approved time window for IV alteplase (tPA) administration in eligible acute ischemic stroke patients per current guidelines?

Accepted Answer

Within 3 to 4.5 hours of symptom onset

Answer

IV alteplase is approved for use within 3 to 4.5 hours of symptom onset in eligible patients, with the extended window supported by the ECASS-3 trial.

Question 5

Wallenberg (lateral medullary) syndrome, caused by PICA occlusion, classically presents with which combination of findings?

Accepted Answer

Ipsilateral facial pain/temperature loss, contralateral body pain/temperature loss, vertigo, and dysphagia

Answer

PICA occlusion causes lateral medullary syndrome with ipsilateral facial sensory loss, contralateral body hemianesthesia (crossed pattern), vertigo, dysphagia, hoarseness, Horner syndrome, and ipsilateral limb ataxia.

Neurologists Exam Practice Test

Neurologists Exam Practice Test

Neurologists Exam Cerebrovascular Disease & Stroke