18th August 2024

You are called to review a 76-year-old gentleman on the stroke unit. He was admitted the previous evening

You are called to review a 76-year-old gentleman on the stroke unit. He was admitted the previous evening with right sided weakness, sensory loss, dysphasia and a right homonymous hemianopia. He has a background of hypertension. A CT head did not demonstrate any haemorrhage and he was given 300 mg aspirin PR. He had been relatively stable, however the nurses call you as the patient has been becoming more drowsy and they are concerned. On examination, he feels clammy. He is rousable to voice only, but there are no other new neurological deficits. He has normal heart sounds but you suspect you hear some crepitations on examination of his chest. His blood pressure is 98/54, heart rate 102 and his temperature is 37.8. Which investigation is most likely to reveal the cause of his deterioration?

Select the SINGLE most appropriate option from the list below. Select ONE option only.