tailieunhanh - Life Long Learning in Neurology - part 3

Nhập một số câu hỏi (ONE TỐT NHẤT ĐÁP) 1. Một phụ nữ 72 tuổi bị tăng huyết áp và tăng lipid máu đột nhiên phát triển trái đồng âm hemianopia buổi sáng ngày hôm qua, và nó đã tồn tại. | 36 Neurocysticercosis occurs when humans replace pigs in the life cycle and become intermediate hosts typically by ingesting food or water contaminated by fecal matter. Stroke Prevention Aug. 2005 TYPE A QUESTIONS ONE BEST ANSWER 1. A 72-year-old woman with hypertension and hyperlipidemia suddenly developed left homonymous hemianopia yesterday morning and it has persisted. She has no history of prior neurological symptoms. Magnetic resonance imaging MRI magnetic resonance angiography MRA shows a subacute right occipital stroke and diffuse large vessel atherosclerotic disease with 60 stenosis of her left vertebral artery 70 stenosis of her right vertebral artery 90 stenosis of her left internal carotid artery ICA and 50 stenosis of her right ICA. An echocardiogram shows no cardioembolic source. Her annual risk of stroke related to the left ICA stenosis is approximately A. 1 to 3 B. 5 to 7 C. 10 to 12 D. 15 to 17 E. 20 to 22 Correct Answer The correct answer is A. This patient s left ICA stenosis is asymptomatic. Her clinical symptoms are consistent with the MRI finding of a subacute right occipital stroke. This implies a problem in the posterior circulation and she has no history or MRI evidence of additional disease in the anterior circulation. Natural history studies reflect an annual stroke risk of between 1 and 3 among persons with an asymptomatic 50 to 99 stenosis of a carotid artery. 2. A 69-year-old man presents to the emergency department with the abrupt onset of right hemiparesis and expressive aphasia 1 hour ago. His past medical history is remarkable for hypertension type 2 diabetes mellitus hypercholesterolemia and smoking. His examination reveals blood pressure of 180 90 mm Hg heart rate 85 min and regular temperature 37 C. He has mild expressive language difficulty and 4 5 weakness in the right arm and leg with drooping of the right lower face. His deficits improve over the next 30 minutes. A computed tomographic CT scan of the head without contrast is