Ischemic stroke Quiz: Ace Your Exams

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A 79-year-old man is brought to the emergency department for evaluation of sudden onset numbness affecting the right upper and lower extremity as well as right sided visual deficit. The patient was playing golf with his son when he suddenly lost the ability to sense holding the golf club with his right hand. He was then unable to get into the golf cart due to “blurry vision.” The patient has a history of poorly controlled hypertension. Temperature is 37°C (98.6°F), pulse is 90/min, and blood pressure is 188/104 mmHg. The patient is alert and oriented. Sensation is decreased in the right arm and leg. Strength testing is intact throughout. A noncontrast head CT is demonstrated below:

A C T scan of a brain shows a large, dark area on the left side, indicating a stroke or lesion. There are also smaller, dark spots within the brain tissue.

A C T scan of a brain shows a large, dark area on the left side, indicating a stroke or lesion. There are also smaller, dark spots within the brain tissue.

Reproduced from: Radiopaedia

Which of the following visual deficits is most likely to be observed in this patient?

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An illustration shows two eyes. The left eye has "L" with a dark quadrant at bottom left. The right eye has "R" with a dark quadrant at bottom right.

An illustration shows two white ovals w/ half-circles of dark blue inside each, left side filled. The left oval has "L", the right has "R".

An illustration shows 2 blue and white oval shapes, each divided down the middle with a C-shape cut out. The left oval has a blue 'L', right oval has a blue 'R'.

An illustration shows two white ovals labeled 'L' and 'R'. Each oval has a dark blue quarter circle in the top right, resembling an eye.

An illustration shows two large eyes, left labeled "L" and right labeled "R". Each eye has a dark blue iris with a white C-shape pupil, creating a half-moon effect.