Patient is experiencing transcortical motor aphasia
– due infarct in the anterior superior frontal lobe (prefrontal cortex) in the perisylvian area of the language-dominant (typically the left) hemisphere. This area is damaged when the ACA is occluded
– the major language networks (Broca’s, Wernicke’s, and the arcuate fasciculus) are therefore unaffectedÂ
– in this stem the patient likely has an ACA infarct on the left and would therefore be expected to have right leg weakness
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R face and arm strength controlled by MCA territoryÂ
Homonymous hemianopia is due to damage in the MCA or PCA supplied structuresÂ
Acalculia and finger agnosia are components of Gerstmann syndrome, which is caused by infarct in the temporal-parietal junctionÂ
Extinction is caused by a non-dominant (usually, right) parietal infarct