14th August 2024

A 69-year-old man with a history of type 2 diabetes, hypertension, and ischaemic heart disease

A 69-year-old man with a history of type 2 diabetes, hypertension, and ischaemic heart disease is brought to the Emergency Department unresponsive. His partner gives a history of recent spells of unsteadiness associated with slurred speech. He found the patient unresponsive approximately 30 minutes ago. On arrival of the ambulance service, there was no respiratory effort, and the ventilation was supported by a supraglottic airway device.

He is assessed in the resuscitation area. On examination, the airway is secured, the chest is clear, and the heart sounds are dual with an ejection systolic murmur. The pulse is irregularly irregular. You note that the eyes are open, and there is horizontal nystagmus but no movement when you speak to the patient from the side. The limbs are globally hypotonic.

An ECG demonstrates atrial fibrillation with normal ventricular rate.

Which is the single more likely location of a lesion on a stroke protocol CT examination?

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