19th July 2023

You review a 48-year-old inpatient admitted with a fever and feeling generally unwell.

You review a 48-year-old inpatient admitted with a fever and feeling generally unwell. He has developed new onset left arm and leg weakness. Positive findings on examination are a left-sided hemianopia, visual neglect, left upper and lower limb weakness and loss of sensation. There is also a diastolic murmur.

Observations: HR 112 regular, BP 133/74, RR 15, SpO2 97% on room air, temperature 37.9.

You suspect the patient has had a stroke.

Which out of the following is the most likely cause?

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