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

Step 1: Understanding the Question:
The question asks which finding is NOT typical when the right middle cerebral artery (MCA) territory is infarcted. The right MCA supplies the right cerebral hemisphere, which in almost all right handed people, and most left handed people too, is the non dominant hemisphere for language.

Step 2: Key Concept:
A right MCA stroke damages the right motor cortex, right face area, and right corticobulbar fibers. Since the right hemisphere is not the language hemisphere in most people, language function stays largely intact. Aphasia is a LEFT, dominant hemisphere function in the vast majority of people.

Step 3: Detailed Explanation:
A right MCA infarct usually causes left sided hemiparesis, because motor fibers cross to the opposite side before reaching the limbs.
It also causes left lower facial weakness, for the same crossed wiring reason.
Dysarthria, which is slurred or poorly articulated speech from weak mouth and tongue muscles, can occur with a lesion on either side, since the muscles of articulation get input from both hemispheres.
Aphasia is a disorder of language content, understanding or producing words and sentences. This function lives in the dominant hemisphere, which is the left side in almost everyone, including most left handed people.
So a right MCA infarct typically spares language and instead produces neglect of the left side of space, denial of illness (anosognosia), and trouble with spatial tasks, not aphasia.

Step 4: Final Answer:
Hemiparesis, facial weakness, and dysarthria are all expected with a right MCA infarct. Aphasia is a left, dominant hemisphere sign and is NOT a usual feature of a right MCA infarct.
Note: the original paper's printed key marks option 4 (Dysarthria) with a question mark, showing the setters themselves were unsure. Based on the crossed and lateralized wiring of language, the medically sound answer is option 1, Aphasia, and this has been corrected here.