18th August 2024

A 40-year-old man presented with visual disturbance for the last week. He reports that he is unable to see things

A 40-year-old man presented with visual disturbance for the last week. He reports that he is unable to see things in the periphery of his vision which he noticed more when he was playing football. He thinks the symptoms began after he had one of his migraines, although the headache resolved as usual after he went to sleep. He is usually well but has a history of migraine with visual aura of fortification spectra; he has never had any visual loss previously. On examination, he has a right superior homonymous hemianopia. CT does not demonstrate any haemorrhage and CTA is normal. MRI demonstrates a small occipital infarct and he is commenced on aspirin. Blood tests performed are normal and his ECG is sinus rhythm. What investigation should the patient undergo next to identify the cause of his infarct?

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