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Original Question

add this to the case study: · The neck is supple, there is no jugular vein distension, and there are no bruits. · The lungs are clear heart sounds regular without murmurs, and abdomen is normal. · The limbs are not well perfused distally. · The neurologic examination reveals that he is alert and oriented, although he does not recognize he is sick. · He shows loss of awareness and attention with respect to objects or stimuli on his left side. · He has mild dysarthria but, his speech is fluent, and he understands and follows commands very well. · There is mild weakness on the left side of the face and left sided homonymous hemaianopsia, but there is no nystagmus or ptosis, and no tongue or uvula deviation. · He is not able to move his left arm and leg, has hyperreflexia, and the left great toe is upgoing.

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