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A Tradesman’s Journey Back from a Cerebral Incident


Diana Colgan
Department of Biology
Kean University
Wajid Mirza
Department of Biology
Kean University
Laura Y. Lorentzen
Department of Biology
Kean University
Kristie Reilly
Department of Biology
Kean University


This directed case study tells the story of a middle-aged man with hypertension and hyperlipidemia who experiences an ischemic cerebrovascular accident. The case provides an opportunity for students to integrate the brain's functional anatomy related to control of speech and body movement, and to examine how disruption of the brain's blood supply can have systemic effects. Students learn the anatomy of the brain's blood supply and explore the neural integration of upper motor neurons in the quadriceps reflex. Group discussion is used to teach the post-stroke symptoms of hemiparesis (primarily in the lower extremity), dysphasia, and alien hand syndrome. The case was originally developed for upper-level undergraduate biology majors following their coursework in anatomy, physiology, and neuroscience. The case is also appropriate for any upper-level college undergraduate or graduate course that covers the cardiovascular system, structure and function of the brain's cerebrum, and the brain's blood supply (circle of Willis and the general supply of each cerebral artery).


  • Apply knowledge of cardiovascular and brain anatomy to a clinical study of a stroke patient.
  • Demonstrate understanding of how ischemic damage to the brain can affect speech, sensory and motor control of body movements, and on rare occasions lead to alien hand syndrome.
  • Identify the brain's cerebral structure and function including its blood supply.
  • Contrast various post stroke effects, specifically flaccidity, spasticity, hemiparesis and dysphasia.
  • Evaluate the source and validity of reference materials used to research the discussion questions.
  • Discuss previous knowledge of the central and peripheral nervous systems in control of body movements, including the upper and lower motor neurons.


Stroke; alien hand syndrome; circle of Willis; hemiparesis; dysphasia; cerebral artery; ischemia; ischemic stroke

Topical Areas


Educational Level

Undergraduate upper division, Graduate, Professional (degree program), Clinical education



Type / Methods

Directed, Analysis/Issues, Discussion, Interrupted



Subject Headings

Anatomy  |   Physiology  |   Medicine (General)  |   Neuroscience  |   Nursing  |  

Date Posted


Teaching Notes

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Answer Key

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The following video(s) are recommended for use in association with this case study.

  • The Circle of Willis: The Man on the Brain
    This video gives a succinct overview of the circle of Willis, employing various mnemonics including the image of a stick figure lying across the pons. Running time: 6:19 min. Produced by Aide Medicale, 2017.