A 72-year-old man speaks fluently and effortlessly, but his speech contains many meaningless words and he cannot follow spoken commands. Which arterial branch is most likely occluded?

• A Superior division of the left middle cerebral artery
• B Left posterior cerebral artery
• C Left anterior cerebral artery
• D Inferior division of the left middle cerebral artery ✓

Explanation

Fluent speech with severely impaired comprehension defines Wernicke aphasia, caused by a lesion of the posterior part of the left superior temporal gyrus, supplied by the inferior division of the middle cerebral artery. The superior division of the MCA supplies the frontal operculum, so its occlusion gives non-fluent Broca aphasia with preserved comprehension. The anterior cerebral artery supplies the medial frontal lobe and leg area of the motor cortex, not the perisylvian language zone.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.