National Physical Therapy Examination (NPTE) Practice Exam

Following a ruptured right middle cerebral artery aneurysm, which functional limitation is a patient most likely to experience?

1. Horizontal nystagmus

2. Ataxic gait

3. Apraxia

4. Rigidity

The correct answer is: Apraxia

The most likely functional limitation a patient would experience following a ruptured right middle cerebral artery aneurysm is apraxia. The middle cerebral artery supplies blood to a large portion of the lateral surface of the cerebral hemispheres, which includes areas of the brain responsible for motor planning and execution, particularly the parietal and frontal lobes. Damage to these areas can lead to apraxia, a condition characterized by difficulty in performing tasks or movements when asked, even though the individual understands the requested action and has the physical capability to perform it. This is related to disruptions in the neural pathways that coordinate and plan voluntary movements. Other options, while they may appear relevant, typically relate to different types of neurological conditions or brain injuries. For instance, horizontal nystagmus is usually associated with vestibular dysfunction or a brainstem issue, which is less likely directly caused by an aneurysm specifically located in the middle cerebral artery territory. Ataxic gait is often associated with cerebellar dysfunction, and rigidity is more characteristic of conditions like Parkinson's disease rather than being directly linked to a ruptured MCA aneurysm. Therefore, apraxia stands out as the most likely consequence of damage related to this specific scenario.