A
previously healthy 46 year old man presented with difficulty
speaking and confusion 5 hours prior to admission. The
patient complained of unspecified eye problems and darkening
of vision on both eyes throughout the previous day.
The patient had a
history of hypertension but currently was not under any
medication. On examination, there was significant expressive
as well as receptive aphasia. The patient also had some
apraxia as well as right sided facial weakness. Limb
strength and sensory exams were essentially intact.
CT of the head
performed without contrast and showed a large left middle
cerebral artery infarct, without shift or evidence of
bleeding.
