A 68-year-old right-handed woman develops sudden right hemiparesis worse in the arm than the leg, with expressive aphasia. Which arterial territory is involved?
- A Left anterior cerebral artery
- B Left middle cerebral artery, superior division ✓
- C Left posterior cerebral artery
- D Right middle cerebral artery, inferior division
Correct answer: B. Left middle cerebral artery, superior division
Explanation
Arm-predominant weakness with expressive (Broca) aphasia localizes to the left frontal operculum and precentral gyrus face-arm region, supplied by the superior division of the left middle cerebral artery. The anterior cerebral artery supplies the medial surface and causes leg-predominant weakness, which kills option A. The inferior division supplies temporal cortex and causes receptive aphasia, while the posterior cerebral artery supplies occipital cortex and causes contralateral homonymous hemianopia.
Reference: Snell's Clinical Neuroanatomy, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.