A 68-year-old man suddenly develops effortful, non-fluent speech with good comprehension and intact repetition of no... wait, he cannot repeat either. He can understand spoken commands but produces telegraphic speech and struggles to name objects. Which cortical region and arterial territory are involved?

• A Inferior frontal gyrus (Brodmann areas 44 and 45), superior division of the middle cerebral artery ✓
• B Superior temporal gyrus, inferior division of the middle cerebral artery
• C Supramarginal gyrus, angular branch of the middle cerebral artery
• D Precentral gyrus operculum, anterior cerebral artery

Explanation

Broca aphasia features non-fluent, telegraphic output with relatively preserved comprehension and impaired repetition, localising to the opercular and triangular parts of the dominant inferior frontal gyrus (Brodmann areas 44 and 45). This region lies in the territory of the superior division of the middle cerebral artery. Option B describes Wernicke aphasia, which shows fluent but meaningless speech with poor comprehension, the opposite profile to this patient.

Reference: Snell's Clinical Neuroanatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.