On one particular day, two patients were brought in to a local emergency room, each with different signs and different prognoses, but each with the same underlying disease, stroke.
The first patient, a 70-year-old male, arrived by ambulance and was accompanied by his elderly wife. The patient was awake and alert, but was unable to move independently due to paralysis on his right side. He looked responsive and seemed to understand what was said to him, but he could not speak. His condition was first discovered by his wife when she woke him that morning. She called 911 when she realized that her husband could not get out of bed, he was unable to move his right arm and leg, and he could not talk to her.
The second patient arrived a few hours later, also by ambulance. Unlike the first patient, this woman was unconscious. She was breathing on her own and she showed no signs of paralysis. Her daughter had discovered her sitting in her chair, slumped over the table. She had been unable to arouse her and called 911.
CAT-scans were done on both patients and confirmed the tentative diagnosis of stroke. They were immediately treated with clot-dissolving drugs, in hopes of stopping more progressive damage. In Patient #1's case, the CAT-scan revealed a blockage in the left middle cerebral artery which supplies the posterior portion of the frontal lobe called the pre-central gyrus. In the case of Patient #2, the blockage was seen in the basilar artery which supplies the brainstem.
What is the function of the two different areas of the brain affected in these two different cases of stroke? How does that account for the differences seen in Patient #1 and Patient #2?
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