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Which of the following arteries supplying the thalamus provides supply to the lateral geniculate nucleus (LGN)?
Which of the following can not passively diffuse across the blood-brain barrier?
The ophthalmic branch of the trigeminal nerve exits the skull from which cranial foramina?
The anatomical structure identified in the image below (blue arrow) derives from which of the following embryonic tissues?
Identify the lesion shown in the imaging below:
The pathology seen in the image below is most likely related to maternal use of which of the following medications?
A 37-year-old female with a past medical history of chronic fatigue and heat intolerance presents with right arm weakness. A cervical spine MRI is performed and shown below (Left: T2 sagittal. Right: T2 axial). Which of the following is the most likely diagnosis?
A 40-year-old male presents with a one-day history of numbness of his right arm. This has never happened before, but he does report an episode of left leg weakness that self-resolved two years ago. The neurological examination confirms a sensory disturbance of his right arm. Sagittal MRI of the cervical spine is shown below (Left: T1, Middle: T1 with contrast, Right: T2). Which of the following is the most likely diagnosis?
Identify the structure (blue arrow) shown below:
The medulla is an embryologic derivative of which of the following structures?
Based on the histopathologic findings shown below, how long ago did this patient experience an ischemic stroke?
You are caring for a 65-year-old that sustained a small hypertensive intracranial hemorrhage. Early physical therapy is initiated. They discover that while she can sit unassisted, she is unable to stand. When standing, she sways and falls forward, backward, or to one side. On a detailed physical exam, strength is 5/5 to flexion and extension at the ankle, knee, hip, shoulder, elbow, and wrist bilaterally.
Which of the following locations of the bleed best explains this finding?
The vessel labeled 1 in the angiogram provided supplies all of the following structures EXCEPT:
A 68-year-old man with an unknown past medical history presents with language difficulties. His spontaneous speech is non-fluent. He has anomia and difficulty following complex tasks, but intact repetition. A solitary lesion in which of the following regions can present with these symptoms?
Socially inappropriate behavior, disinhibition, echopraxia, and utilization behavior are typically seen in which of the following?
A 26-year-old woman presents to the emergency department with third-degree burns covering the entire palmar aspect of her right hand. She claims that she was cooking dinner and touched the stove, but states that she “didn’t notice it was hot”. On neurologic exam, she is unable to distinguish between hot and cold sensations on her hands, arms, shoulders, chest, and back. She also fails to respond to pinprick sensation in the same distribution. She denies any major recent traumatic injuries. Which of the following is the most likely cause of her symptoms?
A 4-month-old boy is brought by his parents due to difficulty in feeding, and episodes of apnea. Physical examination reveals tongue fasciculations, a bulging anterior fontanelle, and an abducens nerve palsy. MRI reveals an Arnold Chiari malformation type II. What additional defect is this child likely to have?
Which of the following is the primary source of norepinephrine in the brain?
A neurology consult is placed on a full-term newborn male after being delivered by an uncomplicated vaginal delivery with good APGAR scores. The physical exam reveals a midline lesion in his lumbar region. Based on the pathology shown below, which of the following would most likely also be present on head imaging?
Which of the following findings is depicted in the catheter angiogram shown?
A 79-year-old woman presented with the acute onset of difficulty walking and nausea that started about 24 hours before presentation. Examination revealed left-beating nystagmus and left-sided appendicular and truncal ataxia. Her axial FLAIR MRI imaging is shown below. The pathology shown is seen in which of the following vascular territories?
Which of the following best describes the clinical features seen in transcortical motor aphasia?
Identify the structure labeled 4 in the angiograms provided below.
Identify the structures labeled in the image below:
What is a common comorbid issue seen in newborns with the vascular abnormality appreciated in the imaging provided?
A 32-year-old female presents to the emergency room after a motor vehicle accident as a restrained back seat passenger. Her only complaint on arrival is back pain. She has bruises across her abdomen and chest and a normal neurological exam. Thoracic spine imaging was completed and is shown below. Which of the following is the most likely diagnosis?
A patient with medically refractory epilepsy secondary to mesial temporal sclerosis recently had a right hemispheric anterior temporal lobectomy. He is complaining of a post-operative visual field deficit. Which of the following is most likely to be appreciated on the exam?
Which of the following arteries provides the prominent supply to the posterior limb of the internal capsule?
Paralysis of the stapedius muscle can occur with ipsilateral damage to which cranial nerve?
Which of the following symptoms can be seen with MCA-PCA watershed infarcts?
A newborn male is evaluated in the NICU for a lesion on his lower back. He was born to a mother with no prenatal care at 37 weeks gestation. Imaging of his lower back shows the meninges and spinal cord herniated through the defect, covered in a membrane. His condition could have most likely been prevented through prenatal supplemental with what?
Which of the following is the relay center for sensory information of the body?
A lesion to which of the following neuroanatomical structures causes dysphagia, decreased gag reflex, and hoarseness?
A 20-year-old male presents with severe burns on his hands after accidentally touching a stove. Neurology was consulted because the family noted that the patient did not initially pull away from the hot stove as one would expect. Physical exam shows decreased sensation of pain and temperature along the back and arms, with intact strength. T2 sagittal MRI of the cervical spine is shown below. Which of the following is commonly associated with the pathology shown?
A 67-year-old male with a past medical history of hypertension and diabetes presents with a 5-day history of facial paralysis and an ear rash. The patient states he returned from a 4-day backpacking trip in the Adirondacks 2 weeks ago in upstate New York where he engaged in hiking and freshwater swimming. His temperature is 36.9 °C (98.5°F), pulse is 72/min, and blood pressure is 131/78. Examination reveals an erythematous vesicular rash in the left auditory canal and pinna and drooping of the left face, forehead, and eyelid. A Weber test lateralizes to the right ear and a Rinne test shows air conduction greater than bone conduction in both ears. What is the most likely diagnosis?
Which of the following is the first branch of the internal carotid artery once it enters the skull?
A 2 month-old female is brought to the emergency room by her mother after she noticed abnormal movements concerning for possible seizure. The child was born at term and was the product of a normal pregnancy and delivery. While gathering a history, the child is lying on the bed still when you notice repetitive movements of his bilateral lower limbs. When her mother notices she picks up the patient and the movements resolve. What is the most likely diagnosis?
Which of the following are actions of the superior rectus muscle?
A 63-year-old woman with right leg weakness and pain has an MRI performed to evaluate for a possible cause. Her imaging is provided below. Based on the location of the lesion, which of the following muscles is most likely weak on examination?
You are asked to see a 64-year-old man with hypertension, hyperlipidemia, and peripheral vascular disease who is post-operative day 1 from an aortic aneurysm repair. On exam, he exhibits bilateral lower extremity weakness, as well as loss of pain and temperature sensation below the umbilicus. Light touch and proprioception are intact in the lower extremities. What is the most likely diagnosis?
Which of the following structures is not primarily involved in the processing and relay of auditory information in the central nervous system?
A 22-year-old female with chronic daily headaches and other neurological symptoms has an MRI performed as part of her diagnostic workup. Her cervical MRI imaging is provided below. In addition to her chronic daily headaches, what are the most likely additional neurological symptoms she experiences?
A 65-year-old male presents with an acute onset of back pain, bilateral lower extremity weakness, and bladder incontinence. A physical exam reveals decreased strength and loss of pain and temperature sensation in both legs. Vibratory and light touch sensation and proprioception remain intact. A lesion to which of the following arteries would most likely be responsible for this clinical presentation?
Which of the following structures has an intact blood-brain barrier?
Oculomotor nerve palsy is most likely to be seen secondary to an aneurysm in which of the following arteries?
What is the anatomical structure marked by the blue arrow?
A 65-year-old male with a history of alcoholic cirrhosis presents to the emergency department with dark black coffee-ground emesis. He is found to have a systolic blood pressure of 76/40 and is tachycardic to 120 BPM. Which nerve is most responsible for carrying the afferent fibers from carotid sinus baroreceptors that cause the reflex increase in heart rate seen in this patient?
According to the Bouthillier Classification, which segment of the internal carotid artery is colored below in orange in this sagittal angiogram?
A 31-year-old man presents after being found down at the scene of an armed robbery. On physical examination, there is lower extremity weakness and loss of proprioception and vibration on the right side, as well as loss of pain and temperature sensation on the left leg. His sagittal CT spine is shown below. Which is the most likely condition suffered by this man?
What is the likely etiology of the findings appreciated on the imaging below?
A patient presents with sudden-onset gait instability and dysphagia. On exam, he has dysmetria of the right hand, anisocoria, loss of pain and temperature of the right face, and loss of pain and temperature of the left arm and leg. An MRI of the brain is performed and shows a stroke. What other symptom is often also a part of the syndrome this patient is experiencing?
Vasogenic edema would be best appreciated on which of the following MRI sequences?
Cerebral amyloid angiopathy would be best appreciated on which of the following MRI sequences?
Which of the following cranial nerve(s) transverses through the structure (blue arrow) shown below?
A 75-year-old woman with HTN presents with sudden memory deficits and a change in emotional regulation. She is found to have a lacunar infarct, and you feel a disconnection of the Papez circuit may explain her symptoms. Which of the following is not considered a part of the Papez circuit?
A 75-year-old female with a past medical history of hypertension on lisinopril presents to the emergency department with weakness on the left side of the body and a drooping right eye. On exam, her right eye is inferiorly and laterally deviated. This pupil is also non-reactive. Her strength is 3/5 on the left side. Where is this patient’s lesion?
A 22-month-old girl presents with her mother for abnormal movements and loss of milestones. The mother describes the patient frequently and repetitively squeezes and twists her hands, and has lost some of her developmental milestones including fine motor skills and verbal speech. She has stopped walking as well. On examination of growth curves, her head circumference percentile appears to have fallen off of the curve. The patient has no other past medical problems, no past trauma, or past infections, and had been developing normally up until now. Of the following, which is most likely true?
Which of the following structures are not supplied by the posterior cerebral artery (PCA)?
Which of the following issues in early development has occurred in the photograph below?
A 25-year-old female with no significant past medical history presents with a two-day history of progressive bilateral lower extremity weakness and numbness. On physical exam, she has 3/5 strength in hip flexion and knee extension bilaterally, along with a loss of sensation. She is up to date on all vaccinations. She is afebrile. Sagittal (left) and axial (right) T2 thoracic MRI images are shown below. Which of the following is the most likely diagnosis?
A 23-year-old female with a history of optic neuritis presents with a 1-week history of left leg weakness. Neurologic examination reveals decreased strength of the left lower extremity. A lumbar puncture reveals oligoclonal bands with lymphocytic pleocytosis. What stain can be used to identify the dysfunctional cells in this condition?
A 55-year-old was recently diagnosed with breast cancer. She required a right mastectomy, lymph node resection, and local radiation. She presents to your clinic with right arm pain and weakness. On exam, she has weakness only to forearm pronation, and flexion at the wrist and biceps. She also has numbness of the lateral hand and the first 3 digits.
Which cord or nerve was likely injured from the surgery or radiation?
A 65-year-old male with a past medical history of diabetes, hypertension, and a 40-pack-year smoking history comes into the ED with an acute onset of ataxia, left facial numbness, right arm, and leg numbness, and dizziness. He also has intractable hiccups. A CTA angiogram shows the cause of the patient’s symptoms. Based on the clinical exam, which of the following arteries is occluded?
Axial T2 (left) and T1 (right) brain MRI images of a 3-month-old with a history of seizures and developmental delay are displayed below. Which of the following is the most likely cause for the pathology shown?
A 56-year-old male presents with unusual behavior of compulsive eating and inappropriate sexual gestures. On exam, the patient has difficulty keeping his hands to himself and is distracted by the objects in his bed. A lesion in which area(s) of the brain would explain this syndrome?
A patient presents with double vision that improves when tilting their head to the right. A lesion is most likely to be present in which of the following cranial nerves?
A lesion to which of the following hypothalamic nuclei causes hyperphagia?
Uncal herniation compressing on the structure marked below (black arrow) would lead to which of the following symptoms?
A 65-year-old female patient presents with right homonymous hemianopsia for the past week. She also says she has difficulty reading but no problems with writing. Which of the following area of the brain is likely affected?
Which of the following is the chemoreceptor trigger zone for vomiting?
A 45-year-old female with a past medical history of hypertension and medication non-adherence presents to the emergency department with weakness on the left side of the body and a drooping right eye. Her blood pressure is 220/100. On physical exam, her right eye is inferiorly and laterally deviated and the pupil is non-reactive. Her strength was 3/5 on the left side. MRI brain identifies an ischemic lesion. Based on the clinical exam, which of the following arteries is most likely the cause of the patient’s symptoms?
A 42-week gestational age female was born vaginally to a mother with a history of type 2 diabetes. Delivery was complicated by shoulder dystocia and required assistance with forceps. Apgar scores at 1 and 5 minutes were seven and nine, respectively. Her birth weight was 9 pounds and 6 ounces. Examination after birth showed there was no appreciable left arm bicep or deltoid function. What is the most likely etiology for this finding?
A 69-year-old female is brought to the emergency room by her daughter for excessive stumbling, often tripping on things on the floor. The daughter also says her mother has been behaving oddly, complaining about seeing darkness in a fully lit room, and the inability to recognize her family members. Bilateral pupillary light reflexes are normal. If symptoms are secondary to an ischemic injury, an MRI would show a lesion in which of the following regions?
Which of the following identifies the sigmoid sinus?
The abnormalities appreciated on the MRI below are due to a defect in which of the following processes?
A blood clot in which artery explains the findings below?
Which of the following can be appreciated on histopathologic analysis of ischemic tissue five hours after an ischemic injury to the cortex?
A lesion to which of the following hypothalamic nuclei can lead to hyperthermia?
A full-term male is having a routine awake and sleep EEG performed because of episodes concerning for possible seizures. These episodes were first noticed four days after an uncomplicated vaginal delivery. On the video EEG recording, you notice a violent jerking of the limbs followed by sustained stiffening after a phone rings loudly in the room. What is the most likely diagnosis?
A 17-month male was brought to the pediatric neurology clinic was brought to the clinic with concerns for developmental delay. Parents note that the child was a product of a normal pregnancy and his delivery was uncomplicated. A developmental delay was appreciated by 8 months of age. He is largely non-verbal. He appears happy in the room, laughing spontaneously without any external stimuli. Which of the following abnormalities most likely explains this developmental disorder?
Which of the following structures is supplied by the recurrent artery of Heubner?
A 65-year-old female presents with an abrupt onset of akinetic mutism, lack of motivation, apathy, bilateral leg weakness, and incontinence. A lesion to which of the following vascular territories could explain her symptoms?
A 35-year-old male with a past medical history of intravenous drug use presents with back pain, fever, anorexia, and generalized weakness. An MRI of his sagittal spine is shown below. Which of the following is the most likely diagnosis?
A 39-year-old male presents to the clinic for hallucinations. His medical history is only remarkable for a chemical accident at his job resulting in severe corneal scarring bilaterally, for which he now requires a seeing-eye dog.
His hallucinations are usually of tall figures dressed in black with long fingers. He is not frightened by this because he knows they are not real. He denies other neurologic deficits, denies auditory hallucinations and describes his mood as “good”. The rest of his exam is normal.
You are familiar with the underlying syndrome the patient is experiencing. You inform the patient that in the rest of the population the most common cause of this syndrome is actually…
Which of the following embryologic derivatives myelinates the peripheral nervous system (PNS)?
Identify the pathological abnormality shown in the image below.
Based on the MRI imaging shown below, which of the following structural abnormalities is likely also present?
Which of the following structures is well myelinated in a full-term (40-week) infant?
Which of the following symptoms is unlikely to be caused by a lesion in the cavernous sinus?
Which of the following is not part of Gerstmann’s syndrome?
A 38-year-old man presents with a 1-year history of neck pain and left upper extremity weakness. The symptoms started insidiously, and have slowly worsened over time. A sagittal cervical spine MRI is shown below (Left: T2 without contrast. Right: T1 with contrast). Which of the following is the most likely cause of his symptoms?
Immunohistochemical staining with GFAP is particularly useful in identifying which of the following cell types?
Which of the following arteries supplies the lumbar spinal cord?
Which of the following cranial nerves is most likely to be affected by increased intracranial pressure?
Which of the following identifies the vein of Galen?
A patient presents to the emergency room with sudden onset weakness and dysphagia. On exam, the patient’s tongue deviates to the left, and there is right hemiparesis and right-sided loss of position and vibratory sensation. Pain and temperature sensation is intact. Which of the following arteries supplies blood to the damaged area?
A 32-year-old obese and pregnant female in her third trimester presents to the clinic with pain and tingling of the lateral thigh with occasional aching in the groin. It is worsened by moving to a standing or sitting position and by wearing tight underwear. She has numbness on the right anterolateral thigh up to the level of the hip. The strength exam is normal. Which nerve is likely affected?
An MRI is ordered on a man with a known history of ischemic stroke and bilateral upper extremity weakness. Which of the following was the most likely cause of his ischemic injury?
Which of the following anatomic structures is responsible for the perception of superficial light touch?
The abnormalities appreciated on the MRI below are due to a defect in which of the following processes?