A 72-year-old woman is brought to the emergency department by her daughter because of left-sided weakness for 1 hour. She does not have headache or blurring of vision. She has hypertension, hypercholesterolemia, type 2 diabetes, and coronary artery disease. She has smoked one half-pack of cigarettes daily for 45 years. Her medications include atorvastatin, amlodipine, metformin, and aspirin. Her temperature is 37°C (98.6°F), pulse is 92/min and regular, and blood pressure is 168/90 mm Hg. Examination shows a left facial droop. A noncontrast head CT is normal. Brain MRI reveals an acute subcortical infarct in the right internal capsule. Six months later, which of the following findings is most likely to be observed in the affected pyramidal tracts of this patient?

Question

A 72-year-old woman is brought to the emergency department by her daughter because of left-sided weakness for 1 hour. She does not have headache or blurring of vision. She has hypertension, hypercholesterolemia, type 2 diabetes, and coronary artery disease. She has smoked one half-pack of cigarettes daily for 45 years. Her medications include atorvastatin, amlodipine, metformin, and aspirin. Her temperature is 37°C (98.6°F), pulse is 92/min and regular, and blood pressure is 168/90 mm Hg. Examination shows a left facial droop. A noncontrast head CT is normal.  Brain MRI reveals an acute subcortical infarct in the right internal capsule.  Six months later, which of the following findings is most likely to be observed in the affected pyramidal tracts of this patient?

Quizplus · Accepted Answer

Eductional Objective: Wallerian degeneration refers to the process of axonal degeneration and breakdown of the myelin sheath that occurs distal to a site of injury.  Axonal regeneration does not occur in the central nervous system due to the persistence of myelin debris, secretion of neuronal inhibitory factors, and development of dense glial scarring.

A 72-Year-Old Woman Is Brought to the Emergency Department by Her