Question

Which of the following is NOT a usual feature of right middle cerebral artery territory infarct?

• A. Aphasia
• B. Hemiparesis
• C. Facial weakness
• D. Dysarthria

Hint:

Language (aphasia) is a dominant, usually left hemisphere, function, not a right hemisphere one.

Answer 1

The Correct Option is A

This question tests whether you know which brain functions live in which hemisphere. The right middle cerebral artery feeds the right hemisphere, and in nearly everyone the right hemisphere does not run language.

1. Aphasia: This is a language problem. Language sits in the dominant hemisphere, the left side in almost all people. A right sided stroke does not usually touch this area, so aphasia is not expected here. This is the odd one out.
2. Hemiparesis: Motor fibers from the right hemisphere cross over and control the left limbs. A right MCA infarct causes left sided weakness, so this is expected.
3. Facial weakness: The same crossed pathway controls the lower face. A right sided stroke gives left lower facial droop, so this is expected too.
4. Dysarthria: This is slurred speech from weak articulation muscles, not a language problem. Both hemispheres feed the muscles of speech, so dysarthria can follow a stroke on either side, including the right.

Three of the four, hemiparesis, facial weakness and dysarthria, are standard findings after a right MCA infarct. Aphasia stands apart because it needs damage to the language dominant hemisphere, which for a right sided stroke is usually spared.

Let's summarize:

• Right hemisphere strokes give left sided weakness and left facial droop through crossed motor pathways.
• Language lives in the left hemisphere in almost everyone, so right sided strokes typically spare speech content, even though articulation (dysarthria) can still be affected.

So the feature that is NOT usual in a right MCA territory infarct is aphasia.