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Left MCA ischaemic stroke — SCE Neurology MCQ

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ModerateStrokeLeft MCA ischaemic strokeSCE Neurology

A 27-year-old woman presented with sudden right facial droop, right arm weakness and expressive dysphasia. On examination, there was right hemiparesis, right hemisensory loss and gaze preference to the left. Initial investigations showed: CT showed no haemorrhage; CT angiography showed left M1 occlusion. What is the most likely diagnosis?

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Correct answer: B — Left MCA ischaemic stroke

The best answer is “Left MCA ischaemic stroke”. UK stroke guidance supports urgent vascular imaging and reperfusion selection, short-course dual antiplatelet therapy for eligible minor stroke or high-risk TIA, decompression for life-threatening swelling, and secondary prevention matched to mechanism. The alternatives “Primary CNS vasculitis”, “Basilar artery occlusion”, “Locked-in syndrome”, “Watershed infarction” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: National Clinical Guideline for Stroke: acute care: https://www.strokeguideline.org/chapter/acute-care/