Rosh Internal Medicine Boost Practice Exam

What symptom would you expect to find in a patient with an embolic event in the left anterior cerebral artery?

1. Broca aphasia

2. Incontinence

3. Contralateral hemiparesis

4. Visual field defects

The correct answer is: Incontinence

In the case of an embolic event specifically in the left anterior cerebral artery, one would typically expect to find incontinence among other neurological symptoms due to the region affected by this artery. The left anterior cerebral artery predominantly supplies the medial aspects of the frontal and parietal lobes, which are involved in the regulation of bladder control and motor functions. Incontinence can occur as a result of disruption in the neural pathways that help control bladder function, which can be affected during a stroke in this region. This is particularly true if the stroke impacts areas associated with the frontal lobe where higher-order control and decision-making regarding voiding are managed. In contrast, while contralateral hemiparesis is a well-known consequence of strokes, it is typically more pronounced in the proximal upper and lower extremities when related to the anterior cerebral artery, often not being the most immediate symptom noted. The other options, such as Broca aphasia and visual field defects, are more associated with strokes affecting the left middle cerebral artery or posterior cerebral artery, while the primary symptoms from the left anterior cerebral artery focus on incontinence and motor deficits.