Case 38 Answers

Basic Human Neuroanatomy

A Clinically Oriented Atlas

Case 38 Answers

1. How would you characterize this patient's language dysfunction?

Fluent aphasia – Conduction aphasia

2. What specific structures are involved to produce the patient’s aphasia?

Left arcuate fasciculus (and nearby structures)

3. Is the right facial weakness of the upper motor neuron or lower motor neuron type?

Upper motor neuron (UMN) facial weakness

4. What specific structures are involved to produce the right UMN facial weakness?

Left corticonuclear (corticobulbar) fibers above the lower third of the pons

5. What specific structures are involved to produce the right-sided weakness?

Left corticospinal fibers above the lower third of the pons

6. What is the location of the neurologic lesion, and which side of the nervous system is involved?

Left hemispheric deep lesion, affecting the arcuate fasciculus and the pyramidal tracts (probably sensory pathways also)

7. In general, what type of pathologic process is involved in this case?

Vascular – Central (penetrating) branches of left MCA

8. What diagnostic procedure would you undertake at this point?

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