18th August 2024

A 35-year-old lady presents with left leg weakness and numbness. She reports that since she woke up

A 35-year-old lady presents with left leg weakness and numbness. She reports that since she woke up this morning she has not been able to move her left leg as normal. She also vomited once this morning, but has otherwise been well aside from a headache which she has had for the last week.. She is known to have a history of “hole in the heart” diagnosed in infancy and she takes no medication other than an oral contraceptive. On examination, you note her BMI is 32 and she is afebrile. She has MRC grade 3 power in her left leg and grade 4+ in her right leg. She reports slight blurring of vision when asked to read and she is slightly dysarthric. A CT head demonstrates bihemispheric infarction with some surrounding oedema. Which investigation will be the most sensitive in diagnosing the cause of the infarct?

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