A 49-year-old man presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness.
Physical examination Temperature: 99°F, pulse rate: 93 bpm, BP: 191/100 mmHg Respiratory rate: 22 breaths per minute, oxygen saturation: 100% while breathing room air Neurological examination Diminished strength in the left upper extremity: 4/5 arm abduction and adduction of the left shoulder; 4/5 elbow and wrist extension and flexion; and 4/5 extension, abduction, and adduction of the digits. The patient also exhibited slight left upper extremity pronator drift. The strength was also diminished in the left lower extremity: 2/5 hip flexion,…
