A 62-year-old man suddenly produces fluent speech that is full of neologisms and paraphasias. He cannot comprehend spoken commands and appears unaware of his deficit. There is no hemiparesis. Which area is most likely infarcted?
- A Superior temporal gyrus of the dominant hemisphere (Brodmann area 22) ✓
- B Inferior frontal gyrus of the dominant hemisphere (Brodmann areas 44 and 45)
- C Angular gyrus of the dominant hemisphere
- D Supramarginal gyrus of the nondominant hemisphere
Correct answer: A. Superior temporal gyrus of the dominant hemisphere (Brodmann area 22)
Explanation
Fluent output with severely impaired comprehension and poor insight defines Wernicke receptive aphasia, caused by a lesion of the posterior part of the superior temporal gyrus (area 22) in the dominant hemisphere, usually within the territory of the inferior division of the middle cerebral artery. The inferior frontal gyrus lesion gives non-fluent Broca aphasia with preserved comprehension, which kills distractor B. Angular gyrus damage causes alexia with agraphia rather than this syndrome.
Reference: Gray's Anatomy for Students, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.