A 72-year-old man with hypertension, diabetes, and active smoking presents with acute onset right-sided weakness, right facial droop, and slurred speech. Vital signs show BP 168/94 mmHg, HR 88 bpm, RR 16, temp 37.2°C, and SpO2 98% on room air. Brain MRI demonstrates acute infarction in the left middle cerebral artery territory with diffusion restriction. Serum glucose is 182 mg/dL. No atrial fibrillation is noted on cardiac monitoring. Which mechanism best explains this stroke?
- A)Cardioembolism from atrial fibrillation
- B)Small vessel lipohyalinosis
- C)Vasculitis from systemic lupus erythematosus
- D)Large artery atherosclerotic diseaseGABARITO
- E)Hypercoagulable state from malignancy
Explicação
Large MCA territory infarction in a patient with atherosclerotic risk factors (age, hypertension, diabetes, smoking) is most consistent with large artery atherosclerotic disease. The MCA is a major vessel commonly affected by atherosclerosis. Ver explicação completa e trilha adaptativa →