18th August 2024

A 40-year-old woman presents with left-sided numbness of sudden onset associated with a headache

A 40-year-old woman presents with left-sided numbness of sudden onset associated with a headache. There is no associated weakness or speech disturbance. She reports that she has had one previous episode of weakness of her right hand side with difficulty picking up objects and speech disturbance which resolved after a number of hours. She has a history of migraines preceded by flashing lights and depression for which she is prescribed sertraline. She reports a family history of migraines and her mother had a stroke aged 45 and her aunt had early onset dementia. Her CT head is normal but an MRI shows an acute lacunar infarct and several old infarcts. You suspect she has an inherited condition, which genetic mutation is the most likely cause?

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