18th August 2024

A 43-year-old woman presents with collapse whilst out shopping with her 10-year old son

A 43-year-old woman presents with collapse whilst out shopping with her 10-year old son. She has a seizure en route to hospital in the ambulance which is terminated with IV lorazepam. She is unable to give any history but the patient’s son informs you that both he and his mother suffer from frequent nosebleeds. On examination, she is aphasic, she has a right hemiparesis with neglect and she has fixed eye deviation to the left. You notice that she has purple spots on her lips and fingers; other examinations of the cardiovascular, respiratory and gastrointestinal systems are normal. There is an obvious haemorrhage on CT scan. What is the likely cause of the patient’s haemorrhagic stroke?

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