Acute Onset Numbness in the Emergency Department

In Episode 66 of Med School Question of the Week for USMLE, Alisa Khomutova, MedSchoolCoach expert tutor, answers this medical school question:

A 62-year-old man is brought to the emergency department because of sudden-onset right sided body numbness for 1 hour. He reports that he has a 15-year history of hypertension treated with hydrochlorothiazide. He is alert and oriented to time, place, and person. Neurological examination shows decreased sensation to light pinprick and temperature on the right side of the face and body. Motor strength is 5/5 and deep tendon reflexes are 2+ bilaterally. Perfusion of which of the following structures of the brain is most likely impaired in this patient?

• Medial Midbrain
• Posterior limb of Internal Capsule
• Lateral Medulla
• Pons
• Subthalamic Nucleus
• Ventral Thalamus
• Parietal Lobe