On the basis of signs and symptoms identified below, where is the lesion most li

Question

On the basis of signs and symptoms identified below, where is the lesion most likely to be localised? Justify your answer on the basis of the history, physical and neurological examination.

(patient presented with - likely to be a transient ischemic attack)

- Headache

- Altered mental status - unable to repeat words, meaningless words/phrases, minor impairment in reading and writing

- memory loss

- Onset confusion

- Cranial nerves - impaired vision on right side

- Rapid speech - (indication of stroke due to weakness of facial muscles)

- Right arm weakness (potential hemiparesis) - no mobility

- BMI (classified as obese)

- Gait (hesitantly took small steps)

- Sensory (Decreased pinprick sensation on the right side)

- Graphesthesia and stereognosis (absent in right arm)

*** Please include references so i will be able to research further, thank you ****

Explanation / Answer

Answer:

-Headache : Subarachnoid space/meninges

- Altered mental status - unable to repeat words, meaningless words/phrases, minor impairment in reading and writing : Subarachnoid space/meninges

- memory loss : Thalamus

- Onset confusion : Brain stem

- Cranial nerves - impaired vision on right side : Brainstem

- Rapid speech - (indication of stroke due to weakness of facial muscles) : Cerebellum

- Right arm weakness (potential hemiparesis) - no mobility : Anterior horn cell

- BMI (classified as obese) : Bone marrow

- Gait (hesitantly took small steps) : Spinal cord

- Sensory (Decreased pinprick sensation on the right side) : Brain stem

- Graphesthesia and stereognosis (absent in right arm) : Nervous system

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