MCA

Question 1

L MCA, S division

Answer 1

R face and arm weakness (UMN)
Nonfluent (Broca’s/expressive) aphasia
R face and arm cortical-type sensory loss may be present

Question 2

L MCA, I division

Answer 2

Fluent (Wernicke’s/receptive) aphasia
R visual field deficit
R face and arm cortical-type sensory loss may also be present
Motor sx usually absent - R-sided weakness may be present @ onset of sx
May seem confused initially

Question 3

L MCA, deep territory

Answer 3

R pure motor hemiparesis (UMN)
Cortical deficits (aphasia) present w/ larger infarcts

Question 4

L MCA, stem

Answer 4

R hemiplegia/-paresis, R hemianesthesia, R homonymous hemianopsia
Global aphasia
Often L gaze preference, esp @ onset (caused by L hemisphere cortical areas that drive eyes to R)

Question 5

R MCA, S division

Answer 5

L face and arm weakness (UMN)
L hemineglect may be present
L face and arm cortical-type sensory loss may be present

Question 6

R MCA, I division

Answer 6

Profound L hemineglect (usually have normal strength on L side)
L visual field and somatosensory deficits (hard to tease out clinically because of neglect)
Motor neglect w/ decreased voluntary or spontaneous initiation of movements on L side may also be present (occasional spontaneous movements or purposeful withdrawal from pain)
Mild L-sided hemiparesis may be present
R gaze preference, esp when acute

Question 7

R MCA, deep territory

Answer 7

L pure motor hemiparesis (UMN)
Cortical deficits (L hemineglect) may be present w/ larger infarcts

Question 8

R MCA, stem

Answer 8

L hemiplegia/-paresis; L hemianesthesia; L homonymous hemianopsia; profound L hemineglect
R gaze preference, esp when acute (because of damage to R hemisphere cortical areas that drive eyes L)