MRCP UK EXAMINATIONS

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NEUROLOGY

HEMIPARESIS

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
  Basilar artery thrombosis / bilateral infarction of ventral pons * Preserved consciousness / sensation * Mutism (anarthria) * Horizontal eye movements impaired * Vertical eye movements and blinking intact ____ Stretching / ROM
A
Vertebrobasilar Artery Syndrome
B
Locked-in Syndrome
C
Either A or B
D
None of the above
Explanation: 

Detailed explanation-1: -Basilar artery infarct or occlusion (BAO) is caused by the obliteration of blood supply to the posterior circulation or vertebrobasilar system of arteries to the brain.

Detailed explanation-2: -It provides oxygen-rich blood to the cerebellum, brainstem, thalamus, occipital, and medial temporal lobes of the brain. Basilar artery thrombosis is a devastating form of stroke with high morbidity and mortality. Its initial presentation is often extremely nonspecific and may include dizziness or blurring of vision.

Detailed explanation-3: -Clinical presentation Clinically, top of the basilar syndrome is characterized by: visual and oculomotor deficits. behavioral abnormalities. somnolence, hallucinations and dreamlike behavior.

Detailed explanation-4: -A stroke of the vertebral or basilar artery should be suspicious in a patient presenting with vestibulocerebellar symptoms, including dizziness, nystagmus, truncal and/or limb ataxia, hypotonia of one side, oscillopsia, or cranial nerve impairment.

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