A 40-year-old man was found to have weakness of the right shoulder and arm 6 hours before presentation. This was followed by weakness of the ipsilateral leg, then left leg, followed by left arm (around-the-clock pattern). Where in the neuraxis is the lesion likely to be present?
Foramen magnum
A sequential 'around-the-clock' pattern of limb weakness spreading from one arm to the ipsilateral leg, then to the contralateral leg and finally the contralateral arm is a classic localizing sign of a lesion at the craniocervical junction/foramen magnum, related to the crossing pattern of corticospinal tract fibres at that level.
Similar Questions
A 47-year-old man with a large frontoparietal lesion in the right hemisphere was asked to circle all the A's. Only targets on the right were circled. This is a manifestation of:
A 42-year-old labourer developed a sudden, severe and persistent headache, accompanied by vomiting and neck pain. He was evaluated at the nearest hospital where an emergency computed tomography was negative for stroke. Which one of the following investigations is best to confirm the diagnosis?
Which of the following features are present in Locked-in syndrome?
1. Cerebral cortex is intact.
2. Bilateral motor tracts are damaged.
3. Some response to verbal stimuli may be present.
4. Limb movement occurs in response to noxious stimuli.
Select the correct answer using the code given below:
Important Questions from Stroke
- Transient Monocular blindness may be due to small platelet emboli that occludes:
- The phenomenon of sparing of macular vision is due to collateral circulation between:
- The commonest cause for new-onset seizures in patients older than 65 years is:
- Ipsilateral $3^{rd}$ cranial nerve palsy with contralateral cerebellar signs is seen in:
- Incongruous contralateral homonymous hemianopia is due to lesion at:
