A 70-year-old man speaks fluently and effortlessly but his sentences are empty of meaning, with frequent paraphasias and neologisms. He cannot follow spoken commands and appears unaware of his deficit. There is no hemiparesis. Which artery territory and cortical region are involved?
- A Superior division of left MCA, inferior frontal gyrus
- B Inferior division of left MCA, posterior superior temporal gyrus ✓
- C Left ACA, medial frontal cortex
- D Left PCA, parahippocampal gyrus
Correct answer: B. Inferior division of left MCA, posterior superior temporal gyrus
Explanation
Fluent speech with impaired comprehension and lack of insight defines Wernicke receptive aphasia, localizing to the posterior part of the superior temporal gyrus, Brodmann area 22, extending to adjacent angular and supramarginal regions. This zone is supplied by the inferior division of the left middle cerebral artery. The inferior frontal gyrus of option A is Broca's area, supplied by the superior division, and its lesion gives nonfluent speech with preserved comprehension and prominent right hemiparesis, which this patient lacks.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.