ABPN VASCULAR NEUROLOGY CERTIFICATION EXAMINATION PRACTICE
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A
Q1. A 65-year-old man presents with sudden right arm weakness and slurred speech. MRI shows an
acute infarct in the left precentral gyrus. Which artery is most likely occluded?
A. Left anterior cerebral artery
B. Left middle cerebral artery
C. Left posterior cerebral artery
D. Basilar artery
Correct Answer: B
Rationale: The middle cerebral artery supplies the lateral frontal and parietal lobes, including the
primary motor cortex for the face and upper limb, explaining right arm weakness .
Q2. A patient has sudden onset of vertigo, nausea, and limb ataxia. MRI shows an infarct in the
cerebellar hemisphere. Which artery is most likely involved?
A. Superior cerebellar artery
B. Posterior inferior cerebellar artery
C. Anterior inferior cerebellar artery
D. Basilar artery
Correct Answer: B
Rationale: The PICA supplies the inferior cerebellum and lateral medulla; infarcts present with vertigo,
limb ataxia, and nausea .
Q3. A 58-year-old woman develops sudden left visual field loss. MRI shows right occipital lobe infarction.
Which artery is most likely occluded?
,A. Right posterior cerebral artery
B. Middle cerebral artery
C. Anterior cerebral artery
D. Internal carotid artery
Correct Answer: A
Rationale: The PCA supplies the occipital cortex, and infarction produces contralateral homonymous
hemianopia .
Q4. A patient presents with sudden right-sided weakness of the face and arm, but normal leg strength.
Which vascular territory is most likely affected?
A. Middle cerebral artery superior division
B. Middle cerebral artery inferior division
C. Anterior cerebral artery
D. Posterior cerebral artery
Correct Answer: A
Rationale: The MCA superior division primarily affects the face and upper limb motor cortex, sparing
the leg .
Q5. A 72-year-old man presents with sudden-onset speech difficulty. He can understand language but
struggles to form words. Which type of aphasia is this?
A. Wernicke's aphasia
B. Broca's aphasia
C. Global aphasia
D. Conduction aphasia
Correct Answer: B
,Rationale: Broca's area in the inferior frontal gyrus is responsible for speech production; damage
causes non-fluent, effortful speech with preserved comprehension .
Q6. A patient develops sudden numbness and weakness on the left side of the body after carotid artery
occlusion. Which vascular territory is most likely affected?
A. Right anterior cerebral artery
B. Right middle cerebral artery
C. Left middle cerebral artery
D. Right posterior cerebral artery
Correct Answer: B
Rationale: Contralateral motor and sensory deficits result from MCA infarction; left-sided deficits
indicate right hemisphere involvement .
Q7. Which of the following is the most common cause of cardioembolic stroke?
A. Large artery atherosclerosis
B. Atrial fibrillation
C. Small vessel disease
D. Dissection
Correct Answer: B
Rationale: Atrial fibrillation can generate thrombi in the left atrial appendage, leading to embolic stroke
.
Q8. A patient presents with sudden onset of "worst headache of my life." CT shows subarachnoid blood.
What is the most common cause?
A. Arteriovenous malformation
, B. Aneurysmal rupture
C. Hypertensive bleed
D. Amyloid angiopathy
Correct Answer: B
Rationale: The majority of spontaneous subarachnoid hemorrhages are due to rupture of saccular
(berry) aneurysms .
Q9. Which artery is most commonly affected in intracerebral hemorrhage due to chronic hypertension?
A. Lenticulostriate arteries
B. Anterior communicating artery
C. Middle meningeal artery
D. Posterior inferior cerebellar artery
Correct Answer: A
Rationale: Hypertension preferentially affects small perforating arteries in the basal ganglia, thalamus,
and pons .
Q10. A 45-year-old woman develops sudden monocular vision loss described as "curtain coming down."
What is the most likely diagnosis?
A. Amaurosis fugax
B. Retinal detachment
C. Optic neuritis
D. Central retinal artery occlusion
Correct Answer: A
Rationale: Amaurosis fugax describes transient monocular blindness, often described as a shade or
curtain descending over the vision .
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A
Q1. A 65-year-old man presents with sudden right arm weakness and slurred speech. MRI shows an
acute infarct in the left precentral gyrus. Which artery is most likely occluded?
A. Left anterior cerebral artery
B. Left middle cerebral artery
C. Left posterior cerebral artery
D. Basilar artery
Correct Answer: B
Rationale: The middle cerebral artery supplies the lateral frontal and parietal lobes, including the
primary motor cortex for the face and upper limb, explaining right arm weakness .
Q2. A patient has sudden onset of vertigo, nausea, and limb ataxia. MRI shows an infarct in the
cerebellar hemisphere. Which artery is most likely involved?
A. Superior cerebellar artery
B. Posterior inferior cerebellar artery
C. Anterior inferior cerebellar artery
D. Basilar artery
Correct Answer: B
Rationale: The PICA supplies the inferior cerebellum and lateral medulla; infarcts present with vertigo,
limb ataxia, and nausea .
Q3. A 58-year-old woman develops sudden left visual field loss. MRI shows right occipital lobe infarction.
Which artery is most likely occluded?
,A. Right posterior cerebral artery
B. Middle cerebral artery
C. Anterior cerebral artery
D. Internal carotid artery
Correct Answer: A
Rationale: The PCA supplies the occipital cortex, and infarction produces contralateral homonymous
hemianopia .
Q4. A patient presents with sudden right-sided weakness of the face and arm, but normal leg strength.
Which vascular territory is most likely affected?
A. Middle cerebral artery superior division
B. Middle cerebral artery inferior division
C. Anterior cerebral artery
D. Posterior cerebral artery
Correct Answer: A
Rationale: The MCA superior division primarily affects the face and upper limb motor cortex, sparing
the leg .
Q5. A 72-year-old man presents with sudden-onset speech difficulty. He can understand language but
struggles to form words. Which type of aphasia is this?
A. Wernicke's aphasia
B. Broca's aphasia
C. Global aphasia
D. Conduction aphasia
Correct Answer: B
,Rationale: Broca's area in the inferior frontal gyrus is responsible for speech production; damage
causes non-fluent, effortful speech with preserved comprehension .
Q6. A patient develops sudden numbness and weakness on the left side of the body after carotid artery
occlusion. Which vascular territory is most likely affected?
A. Right anterior cerebral artery
B. Right middle cerebral artery
C. Left middle cerebral artery
D. Right posterior cerebral artery
Correct Answer: B
Rationale: Contralateral motor and sensory deficits result from MCA infarction; left-sided deficits
indicate right hemisphere involvement .
Q7. Which of the following is the most common cause of cardioembolic stroke?
A. Large artery atherosclerosis
B. Atrial fibrillation
C. Small vessel disease
D. Dissection
Correct Answer: B
Rationale: Atrial fibrillation can generate thrombi in the left atrial appendage, leading to embolic stroke
.
Q8. A patient presents with sudden onset of "worst headache of my life." CT shows subarachnoid blood.
What is the most common cause?
A. Arteriovenous malformation
, B. Aneurysmal rupture
C. Hypertensive bleed
D. Amyloid angiopathy
Correct Answer: B
Rationale: The majority of spontaneous subarachnoid hemorrhages are due to rupture of saccular
(berry) aneurysms .
Q9. Which artery is most commonly affected in intracerebral hemorrhage due to chronic hypertension?
A. Lenticulostriate arteries
B. Anterior communicating artery
C. Middle meningeal artery
D. Posterior inferior cerebellar artery
Correct Answer: A
Rationale: Hypertension preferentially affects small perforating arteries in the basal ganglia, thalamus,
and pons .
Q10. A 45-year-old woman develops sudden monocular vision loss described as "curtain coming down."
What is the most likely diagnosis?
A. Amaurosis fugax
B. Retinal detachment
C. Optic neuritis
D. Central retinal artery occlusion
Correct Answer: A
Rationale: Amaurosis fugax describes transient monocular blindness, often described as a shade or
curtain descending over the vision .
