Chapter 6 Ischemic Disease Of The Brain And Spinal Cord PDF

106 Ischemic Disease of the Brain and Spinal Cord QUESTIONS 1. Which statement is true about subclavian steal? A) It is always accompanied by blood pressure asymmetr...

106 Ischemic Disease of the Brain and Spinal Cord QUESTIONS 1. Which statement is true about subclavian steal? A) It is always accompanied by blood pressure asymmetry in the two arms. B) It is accompanied by symptoms of brainstem ischemia in most patients. C) It is caused by stenosis or occlusion of the left subclavian artery proximal to the origin of the left common carotid artery. D) It can be treated with a subclavian stent if subclavian stenosis, but not occlusion, is present. E) It can be treated surgically with axillo-axillary bypass or carotid-subclavian bypass. 2. Occlusion of the left subclavian artery proximal to the origin of the left vertebral artery results in A) Ischemic necrosis of the left arm B) Reduction of flow in the right vertebral artery C) Reduction of flow in the left vertebral artery D) Increase of flow in the right carotid artery E) Reduction of flow in the left carotid artery 3. Which statement is true about Wallenberg’s (lateral medullary) syndrome? A) Is more often associated with an isolated lesion of the posterior inferior cerebellar artery (PICA) than a lesion of the vertebral artery (VA) B) Can be associated with skew deviation of the eyes, but not forced gaze deviation C) Both dysphagia and hoarseness are present in more than half of the patients D) Is rarely or never associated with hiccups E) Is rarely accompanied by headache 4. Which statement is true about Wallenberg’s (lateral medullary) syndrome? A) It is generally associated with a good functional outcome B) It is associated with a high risk of aspiration pneumonia C) It frequently results in poststroke pain D) Patients frequently present with drooling E) All of the above 5. Which statement is true about infarction of the medial medulla? A) Poststroke pain is an uncommon sequel of medial medullary infarction. B) The most common vascular lesion is vertebral artery atherosclerosis with atheromatous branch occlusion. C) The prognosis for motor recovery is generally favorable. (continued) ANSWERS TO THIS SECTION CAN BE FOUND ON PAGE 103 91 92 ISCHEMIC DISEASE OF THE BRAIN AND SPINAL CORD D) Vertigo is uncommon. E) Diplopia does not occur. 6. The syndrome of the anterior choroidal artery (AChA) A) Is a well-defined constellation of symptoms, with hemiparesis without hemisensory loss, a homonymous upper and lower field defect sparing the horizontal meridian, and absence of higher cortical function deficit B) May affect the thalamus but not the brainstem C) Produces symptoms in the classic territories of both anterior and posterior circulation D) Most often has a gradual, stuttering onset E) Produces a visual field defect from involvement of the visual cortex. 7. Which statement is true about limb-shaking transient ischemic attacks (TIAs)? A) They are most often caused by platelet emboli. B) Platelet inhibition is the preventative treatment of choice. C) They are most often associated with EEG changes, suggesting seizures. D) They may be induced by exercise. E) They are not associated with moyamoya disease. 8. Prosopagnosia is A) An amnestic syndrome B) Thought to be related to damage to the right fusiform gyrus C) Most often associated with a right hemianopia D) Almost always caused by stroke E) Never inherited 9. Pseudobulbar affect A) Is related to loss of cortico-pontine-cerebellar circuits B) Is related to excess glutamatergic transmission and decreased serotonergic transmission C) Includes inappropriate outbursts of laughing or crying not precipitated by events appro- priate to these emotions, along with spastic dysarthria in many cases D) Occurs most often in amyotrophic lateral sclerosis (ALS) and stroke, but also with multiple sclerosis (MS) and Parkinson’s disease E) All of the above 10. Which statement best describes intravascular lymphoma? A) The central nervous system (CNS) and skin are the most common areas of involvement. B) Intravascular lymphoma (IVL) is usually derived from T cells that have invaded vessels from the parenchyma. C) Systemic, nonneurological symptoms present early and generally indicate the diagnosis. D) A characteristic ”butterfly lesion” is seen crossing the corpus callosum on MRI. E) Despite brain involvement, the prognosis is generally favorable. 11. Which statement is true about recommendations from the guidelines for secondary stroke prevention? A) The target levels for blood pressure control are systolic