[MCQ] Cerebrovascular Diseases Ischemic stroke- Part 6

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Cerebrovascular Diseases Ischemic stroke- Part 6

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Question 1

What is the annual stroke rate in the natural history of asymptomatic carotid stenosis ?

A	~ 1 %
B	~ 2 %
C	~ 3 %
D	~ 4 %

Question 2

What is the annual stroke rate in the natural history of symptomatic carotid stenosis ?

A	~ 10 %
B	~ 11 %
C	~ 12 %
D	~ 13 %

Question 2 Explanation:

The natural history of asymptomatic carotid stenosis is ~2% per year stroke rate, while symptomatic patients experience a 13% per year risk of stroke

Question 3

SAPPHIRE, CREST, and ICSS pertain to which of the following ?

A	Anticoagulation in stroke
B	Use of atherothrombotics in TIA/stroke
C	Carotid artery stenting and angioplasty
D	Extracranial-to-intracranial (EC-IC) bypass surgery

Question 3 Explanation:

Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) trial was done in high risk patients with symptomatic carotid stenosis >50% or asymptomatic stenosis >80% by either stenting combined with a distal emboli-protection device or endarterectomy. Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) and International Carotid Stenting (ICSS) trial also studied symptomatic patients treated with stents or endarterectomy

Question 4

Which of the following is a category of stroke syndromes ?

A	Large vessel stroke within anterior circulation
B	Large-vessel stroke within posterior circulation
C	Small-vessel disease of either vascular bed
D	All of the above

Question 4 Explanation:

Stroke syndromes are divided into large vessel stroke within anterior circulation, large-vessel stroke within posterior circulation and small-vessel disease of either vascular bed.

Question 5

Occlusion of proximal MCA is most often due to ?

A	Embolus
B	Intracranial atherothrombosis
C	Vasospasm
D	None of the above

Question 5 Explanation:

Occlusion of proximal MCA or one of its major branches is mostly due to embolus (artery-to-artery, cardiac) rather than intracranial atherothrombosis.

Question 6

Cortical branches of MCA supply which of the following ?

A	Frontal pole
B	Lower temporal pole convolution
C	Occipital pole convolution
D	None of the above

Question 6 Explanation:

Cortical branches of MCA supply the lateral surface of hemisphere except for frontal pole and a strip along the superomedial border of frontal and parietal lobes (supplied by ACA), and lower temporal and occipital pole convolutions (supplied by PCA).

Question 7

Lenticulostriate arteries from proximal MCA (M1 segment) supply all except ?

A	Putamen
B	Outer globus pallidus
C	Anterior limb of internal capsule
D	Body of caudate nucleus

Question 7 Explanation:

Proximal MCA (M1 segment) gives rise to penetrating lenticulostriate arteries that supply putamen, outer globus pallidus, posterior limb of internal capsule, adjacent corona radiata & most of caudate nucleus.

Question 8

Temporal cortex is supplied by ?

A	Inferior division of MCA
B	Superior division of MCA
C	ACA
D	PCA

Question 8 Explanation:

MCA divides into superior & inferior divisions (M2 branches) in sylvian fissure. Branches of the inferior division supply inferior parietal and temporal cortex, and superior division supply the frontal and superior parietal cortex.

Question 9

In a right handed person, occlusion of right MCA leads to all except ?

A	Global aphasia
B	Anosognosia
C	Constructional apraxia
D	Dysarthria

Question 9 Explanation:

Global aphasia occurs when the dominant hemisphere is involved. When nondominant hemisphere is affected, anosognosia, constructional apraxia, and neglect are found. Contralateral hemiplegia, hemianesthesia, homonymous hemianopia occur in both instances. Dysarthria is common because of facial weakness.

Question 10

Which of the following artery supplying dominant hemisphere is occluded in Wernicke’s aphasia without weakness ?

A	Stem of MCA
B	Penetrating lenticulostriate arteries of MCA
C	Proximal superior division of MCA
D	Inferior division of MCA

Question 10 Explanation:

If a fluent (Wernicke’s) aphasia occurs without weakness, inferior division of MCA supplying posterior part (temporal cortex) of dominant hemisphere is probably involved

Question 11

Which of the following artery supplying the nondominant hemisphere is occluded in a case of hemineglect or spatial agnosia without weakness ?

A	Stem of MCA
B	Penetrating lenticulostriate arteries of MCA
C	Proximal superior division of MCA
D	Inferior division of MCA

Question 11 Explanation:

Hemineglect or spatial agnosia without weakness indicates that the inferior division of MCA in the nondominant hemisphere is occluded

Question 12

Which of the following artery is occluded in a case of pure motor stroke contralateral to the lesion ?

A	Stem of MCA
B	Penetrating lenticulostriate arteries of MCA
C	Proximal superior division of MCA
D	Inferior division of MCA

Question 12 Explanation:

Occlusion of a lenticulostriate vessel of MCA produces lacunar stroke within the internal capsule producing pure motor stroke or sensory-motor stroke contralateral to the lesion

Question 13

Lacunar infarction affecting which of the following areas produces very few clinical signs ?

A	Genu of internal capsule
B	Posterior limb of internal capsule
C	Globus pallidus and putamen
D	All of the above

Question 13 Explanation:

Lacunar infarction affecting the globus pallidus and putamen often produce few clinical signs, but parkinsonism and hemiballismus occur.

Question 14

Anterior cerebral artery (ACA) arises from the Internal carotid artery at the level of ?

A	Anterior clinoid process
B	Optic chiasma
C	Optic nerve
D	Olfactory trigone

Question 15

“Recurrent artery of Heubner” supplies which part of internal capsule ?

A	Anterior limb
B	Genu
C	Posterior limb
D	Retrolentiform part

Question 16

“Recurrent artery of Heubner” is a branch of ?

A	Internal carotid artery
B	Anterior cerebral artery
C	Middle cerebral artery
D	Posterior cerebral artery

Question 16 Explanation:

Johann Otto Leonhardt Heubner (1843-1926) described this artery in 1872. He also described syphilitic endarteritis (Heubner's disease). Lenticulostriate Recurrent artery of Heubner (RAH) supplies parts of basal ganglia and anterior limb of internal capsule and can be damaged with improper clip placement during repair of aneurysms near the anterior communicating artery

Question 17

“Arteria termatica of Wilder” is a branch of ?

A	Internal carotid artery
B	Anterior cerebral artery
C	Middle cerebral artery
D	Posterior cerebral artery

Question 17 Explanation:

Wilder was the first to describe fusion of both A2 segments to form a single artery & introduced the term arteria termatica of Wilder in 1885. Also known as the unpaired pericallosal stem artery, unpaired anterior cerebral artery, common anterior cerebral trunk & azygos pericallosal artery

Question 18

Which of the following is not supplied by the deep penetrating branches of the A1 segment of ACA ?

A	Anterior limb of internal capsule
B	Amygdala
C	Body of caudate nucleus
D	Anterior hypothalamus

Question 18 Explanation:

The A1 segment of anterior cerebral artery (ACA) gives rise to deep penetrating branches that supply the anterior limb of internal capsule, anterior perforate substance, amygdala, anterior hypothalamus, and inferior part of the head of caudate nucleus.

Question 19

Occlusion of a single A2 segment of anterior cerebral artery (ACA) results in which of the following ?

A	Abulia
B	Bilateral pyramidal signs with paraparesis
C	Urinary incontinence
D	All of the above

Question 19 Explanation:

Occlusion of a single A2 segment of ACA results in profound abulia, bilateral pyramidal signs with paraparesis and urinary incontinence.

Question 20

Anterior choroidal artery arises from ?

A	Internal carotid artery
B	Middle cerebral artery
C	Anterior cerebral artery
D	Posterior cerebral artery

Question 20 Explanation:

Anterior choroidal artery arises from ICA & supplies posterior limb of internal capsule & white matter posterolateral to it, through which geniculocalcarine fibers pass partly.

Question 21

Complete syndrome of anterior choroidal artery occlusion consists of ?

A	Contralateral hemiplegia
B	Hemianesthesia
C	Homonymous hemianopia
D	All of the above

Question 21 Explanation:

The complete syndrome of anterior choroidal artery occlusion consists of contralateral hemiplegia, hemianesthesia and homonymous hemianopia

Question 22

Anterior choroidal strokes are usually the result of ?

A	Embolus
B	Thrombosis
C	Vasospasm
D	None of the above

Question 22 Explanation:

Anterior choroidal strokes are usually the result of in situ thrombosis, and iatrogenic occlusion during surgical clipping of aneurysms of ICA.

Question 23

“Fetal posterior cerebral artery” refers to ?

A	Single PCA
B	Absent PCA
C	PCA arising from internal carotid artery (ICA)
D	PCA arising from MCA

Question 23 Explanation:

Anatomic configuration of PCA arising from ICA is called fetal posterior cerebral artery (20%).

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See all quizzes of Cerebrovascular Diseases Ischemic stroke at here:

Cerebrovascular Diseases Ischemic stroke- Part 1| Cerebrovascular Diseases Ischemic stroke- Part 2| Cerebrovascular Diseases Ischemic stroke- Part 3|Cerebrovascular Diseases Ischemic stroke- Part 4|Cerebrovascular Diseases Ischemic stroke- Part 5| Cerebrovascular Diseases Ischemic stroke- Part 6| Cerebrovascular Diseases Ischemic stroke- Part 7|Cerebrovascular Diseases Ischemic stroke- Part 8

1 What is the annual stroke rate in the natural history of asymptomatic
carotid stenosis ?
A. ~ 1 %
B. ~ 2 %
C. ~ 3 %
D. ~ 4 %
2 What is the annual stroke rate in the natural history of symptomatic
carotid stenosis ?
A. ~ 10 %
B. ~ 11 %
C. ~ 12 %
D. ~ 13 %

3 SAPPHIRE, CREST, and ICSS pertain to which of the following ?
A. Anticoagulation in stroke
B. Use of atherothrombotics in TIA/stroke
C. Carotid artery stenting and angioplasty
D. Extracranial-to-intracranial (EC-IC) bypass surgery

4 Which of the following is a category of stroke syndromes ?
A. Large vessel stroke within anterior circulation
B. Large-vessel stroke within posterior circulation
C. Small-vessel disease of either vascular bed
D. All of the above

5 Occlusion of proximal MCA is most often due to ?
A. Embolus
B. Intracranial atherothrombosis
C. Vasospasm
D. None of the above

6 Cortical branches of MCA supply which of the following ?
A. Frontal pole
B. Lower temporal pole convolution
C. Occipital pole convolution
D. None of the above

7 Lenticulostriate arteries from proximal MCA (M1 segment) supply
all except ?
A. Putamen
B. Outer globus pallidus
C. Anterior limb of internal capsule
D. Body of caudate nucleus

8 Temporal cortex is supplied by ?
A. Inferior division of MCA
B. Superior division of MCA
C. ACA
D. PCA

9 In a right handed person, occlusion of right MCA leads to all
except ?
A. Global aphasia
B. Anosognosia
C. Constructional apraxia
D. Dysarthria

10 Which of the following artery supplying dominant hemisphere is
occluded in Wernicke’s aphasia without weakness ?
A. Stem of MCA
B. Penetrating lenticulostriate arteries of MCA
C. Proximal superior division of MCA
D. Inferior division of MCA

11 Which of the following artery supplying the nondominant
hemisphere is occluded in a case of hemineglect or spatial agnosia
without weakness ?
A. Stem of MCA
B. Penetrating lenticulostriate arteries of MCA
C. Proximal superior division of MCA
D. Inferior division of MCA

12 Which of the following artery is occluded in a case of pure motor
stroke contralateral to the lesion ?
A. Stem of MCA
B. Penetrating lenticulostriate arteries of MCA
C. Proximal superior division of MCA
D. Inferior division of MCA

13 Lacunar infarction affecting which of the following areas produces
very few clinical signs ?
A. Genu of internal capsule
B. Posterior limb of internal capsule
C. Globus pallidus and putamen
D. All of the above

14 Anterior cerebral artery (ACA) arises from the Internal carotid
artery at the level of ?
A. Anterior clinoid process
B. Optic chiasma
C. Optic nerve
D. Olfactory trigone
15 “Recurrent artery of Heubner” supplies which part of internal capsule ?
A. Anterior limb
B. Genu
C. Posterior limb
D. Retrolentiform part
16 “Recurrent artery of Heubner” is a branch of ?
A. Internal carotid artery
B. Anterior cerebral artery
C. Middle cerebral artery
D. Posterior cerebral artery

17 “Arteria termatica of Wilder” is a branch of ?
A. Internal carotid artery
B. Anterior cerebral artery
C. Middle cerebral artery
D. Posterior cerebral artery

18 Which of the following is not supplied by the deep penetrating
branches of the A1 segment of ACA ?
A. Anterior limb of internal capsule
B. Amygdala
C. Body of caudate nucleus
D. Anterior hypothalamus

19 Occlusion of a single A2 segment of anterior cerebral artery (ACA)
results in which of the following ?
A. Abulia
B. Bilateral pyramidal signs with paraparesis
C. Urinary incontinence
D. All of the above

20 Anterior choroidal artery arises from ?
A. Internal carotid artery
B. Middle cerebral artery
C. Anterior cerebral artery
D. Posterior cerebral artery

21 Complete syndrome of anterior choroidal artery occlusion consists
of ?
A. Contralateral hemiplegia
B. Hemianesthesia
C. Homonymous hemianopia
D. All of the above

22 Anterior choroidal strokes are usually the result of ?
A. Embolus
B. Thrombosis
C. Vasospasm
D. None of the above

23 “Fetal posterior cerebral artery” refers to ?
A. Single PCA
B. Absent PCA
C. PCA arising from internal carotid artery (ICA)
D. PCA arising from MCA

Cerebrovascular Diseases Ischemic stroke

[MCQ] Cerebrovascular Diseases Ischemic stroke- Part 6

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Cerebrovascular Diseases Ischemic stroke- Part 6

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