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NBME 21 Answers

nbme21/Block 4/Question#49

A 76-year-old man comes to the physician because of ...

Left thalamus

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 +5  upvote downvote
submitted by tinydoc(39),

Neuropathic Pain after stroke is central Post stroke pain Syndrome

caused by contralateral thalamic lesions

Pg. 504 FA19

 +2  upvote downvote
submitted by neonem(227),

I think you can know that this is a thalamic stroke rather than cortical because a cortical stroke occurring only in the postcentral gyrus (primary sensory cortex) and involving the entire homunculus without affecting the nearby precentral gyrus (primary motor cortex) is very unlikely.

sahusema  Ya I think this question is trying to test your knowledge between a cortical lesion and a subcortical lesion. +  
cienfuegos  Central Stroke Syndrome: Neuropathic pain due to thalamic lesions. Initial paresthesias followed in weeks to months by allodynia (ordinarily painless stimuli cause pain) and dysesthesia on the contralateral side. Occurs in 10% of stroke patients. FA 2018 499 +