A hypertensive individual had a sudden headache and became unconscious within a few minutes. On regaining consciousness, there was complete flaccid hemiplegia with no involvement of upper face, absence of tendon reflexes and a positive Babinski sign. Which one of the following arteries could have ruptured –

**Core Concept**
The patient's symptoms suggest a stroke with involvement of the motor cortex and the corticospinal tract, leading to hemiplegia, and the absence of upper face involvement points towards a specific vascular territory. The absence of tendon reflexes and the presence of a positive Babinski sign indicate upper motor neuron lesion.

**Why the Correct Answer is Right**
The patient's symptoms are consistent with a rupture of the MCA (Middle Cerebral Artery) aneurysm, specifically affecting the motor cortex and the corticospinal tract. The MCA supplies the lateral surface of the hemisphere, including the motor cortex, and the corticospinal tract. The absence of upper face involvement suggests that the frontal eye field, which is supplied by the ACA (Anterior Cerebral Artery), is not affected. The presence of a positive Babinski sign indicates an upper motor neuron lesion.

**Why Each Wrong Option is Incorrect**
**Option A:** The basilar artery supplies the brainstem and the posterior cerebral arteries, which are not primarily involved in the patient's symptoms.
**Option B:** The posterior cerebral artery supplies the occipital lobe and the temporal lobe, which are not primarily involved in the patient's symptoms.
**Option C:** The anterior cerebral artery supplies the medial surface of the hemisphere, including the frontal lobe, but the absence of upper face involvement suggests that the ACA is not primarily involved.

**Clinical Pearl / High-Yield Fact**
In patients with sudden onset of hemiplegia, the absence of upper face involvement suggests involvement of the MCA or PCA, while the presence of upper face involvement suggests involvement of the ACA or the brainstem.

**Correct Answer:** C.

✓ Correct Answer: A. Lateral striate branch of middle cerebral