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Neurology · USMLE Step 1

USMLE Neurology: Stroke and Cerebrovascular Disease

Ischemic and hemorrhagic stroke syndromes matched to the vascular territory and resulting deficits tested on USMLE Step 1.

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Which artery occlusion causes contralateral leg and foot weakness/sensory loss greater than the arm or face?
Anterior cerebral artery (ACA)
Which artery occlusion causes contralateral face and arm weakness greater than the leg?
Middle cerebral artery (MCA)
A stroke in the dominant hemisphere MCA territory typically causes what language deficit?
Aphasia
A stroke in the non-dominant (right) parietal lobe typically causes what deficit?
Hemispatial (contralateral) neglect
Occlusion of which artery causes contralateral homonymous hemianopia with macular sparing?
Posterior cerebral artery (PCA)
What type of small penetrating arteries are most commonly affected in lacunar strokes?
Lenticulostriate arteries
A pure motor lacunar stroke most commonly occurs in which structure?
Posterior limb of the internal capsule
Occlusion of the anterior choroidal artery classically causes what triad of deficits?
Contralateral hemiplegia, hemianesthesia, and homonymous hemianopia
Occlusion of the basilar artery classically causes what syndrome?
Locked-in syndrome
In locked-in syndrome, which functions are typically preserved?
Consciousness and vertical eye movements/blinking
Occlusion of the posterior inferior cerebellar artery (PICA) causes what named syndrome?
Lateral medullary syndrome (Wallenberg syndrome)
In Wallenberg syndrome, damage to the nucleus ambiguus causes what deficits?
Dysphagia, hoarseness, and dysarthria
In Wallenberg syndrome, damage to the spinal trigeminal nucleus causes what deficit?
Ipsilateral loss of pain and temperature sensation on the face
In Wallenberg syndrome, damage to the spinothalamic tract causes what deficit?
Contralateral loss of pain and temperature sensation on the body
In Wallenberg syndrome, damage to descending sympathetic fibers causes what finding?
Ipsilateral Horner syndrome

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