A 70-year-old right-handed man presents with fluent, paraphasic speech and severely impaired comprehension, repeating only single words. He cannot follow commands but appears frustrated and unaware of his errors. Which vascular territory is affected?

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

Explanation

Fluent speech with impaired comprehension and repetition defines Wernicke (receptive) aphasia, caused by infarction of the posterior superior temporal gyrus in the territory of the inferior division of the dominant middle cerebral artery. The superior division supplies Broca area and causes non-fluent expressive aphasia with good comprehension. Posterior cerebral artery infarcts produce visual field defects rather than aphasia, and anterior cerebral artery strokes affect the medial frontal lobe and lower limbs.

Reference: Adams and Victor's Principles of Neurology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.