American Board of Psychiatry and Neurology (ABPN) Practice Exam 2025 – Comprehensive All-in-One Guide to Exam Success!

The presence of thin gyri, wide sulci, and enlarged ventricles is indicative of significant cerebral atrophy and is often associated with neurodegenerative conditions or chronic brain damage. In the context of the provided answer, a lacunar infarct is least likely to be associated with these findings.

Lacunar infarcts are small, deep brain infarctions typically resulting from hypertension or other vascular issues. They often cause localized damage without leading to the widespread atrophy that results in noticeably thin gyri and wide sulci across larger portions of the brain. Consequently, while a lacunar infarct can lead to neurological deficits, it does not typically produce the global changes observed in imaging of those with neurodegenerative diseases or chronic alcoholism.

In contrast, conditions such as Alzheimer's disease and chronic alcoholism can manifest with the atrophic changes characterized by the findings mentioned. Schizophrenia is also known to include alterations in brain structure such as enlarged ventricles, though the specific pattern of atrophy may be less pronounced than in Alzheimer's disease or chronic alcohol abuse.

Thus, the characteristic atrophy of thin gyri and wide sulci, along with the enlargement of ventricles, aligns less with the localized and specific changes seen in a lacunar infarct when compared to