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Case Presentation of Possible Stroke patient

Case Presentation of Possible Stroke patient

I am a medical student trying to piece together the diagnosis of a particular case, please help! The following is the shortest and most HIPPA friendly presentation:

82 yo white female found by police slumped on her kitchen floor in her own feces, brought into ER. Pt is too disorientated to give a chief complaint.

pt has a Hx of short attention loss and "mild" dementia. The pt's family has noticed that as of late she is wearing the same clothes for days and not feeding herself as of the last month. Pt lives alone and still drives a car.

No other Hx of medical problems.

BP 124/80, HR 54, RR 20
General: Pleasant disposition. Skin pink warm and dry
HEENT: Right side facial droop that is beginning to improve.
Right side loss of vision (field: unable to assess d/t patient inability to understand complex questions)
No Uvula deviation.

Neurological: pt is alert and orientated x3, but unable to follow commands and perform multiple step directions.
(Unable to understand when asked where to find the doctor's name when he holds the name tag in front of her.)
Right side upper extremity weakness (2/5) and loss of sensation. (ex. can't touch right hand to nose.)
Right side lower extremity weakness and + babinski reflex.

Labs: UA: + UTI, glucose: 113, Hct mildly low, RBC mildly low, BUN norm, Electrolytes norm, Cardiac enzymes norm, Brain CT norm. Blood cultures neg.

What area of the brain would cause a right facial droop and a right side body weakness? I would say the parietal area of the left side of the brain, but it is both UE & LE as well as the face, and there is a marked cognitive decline.

Could you please direct me to some literature or books wherein I can determine the areas of the brain that could be affected in this patient? Or perhaps, steer me towards a more specific differential?

I appreciate your time and consideration.
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