At 0800, a 72-year-old client is brought to the emergency department by the spouse, who reports the client was speaking normally at 0715 during breakfast and then suddenly could not get words out. The client understands simple requests but answers in short, effortful phrases. History includes hypertension, hyperlipidemia, migraine with aura since age 30, and a single seizure after a fall in 2014; the client takes no anticonvulsant or anticoagulant. The spouse saw no shaking, and the client reports no headache or visual change today. The eyes deviate toward the left, there is a right lower facial droop, and the right arm drifts to the bed when held up. The client wears a hearing aid in the right ear and has months of nighttime right-hand tingling, diagnosed last year as carpal tunnel syndrome. Vital signs: BP 178/96 mm Hg (unchanged on repeat at 0805 and similar to home readings), HR 88/min, RR 18/min, temperature 36.8 C, SpO2 96% on room air. Point-of-care glucose 118 mg/dL.
0800時，72歲的個案由配偶帶到急診室，配偶表示個案在早餐期間0715時說話正常，然後突然說不出話來。個案能理解簡單的指令，但回答時使用簡短、費力的詞句。病史包括高血壓、高血脂、30歲起有預兆的偏頭痛，以及2014年跌倒後的一次癲癇發作；個案沒有服用抗癲癇藥或抗凝血劑。配偶沒有看到顫抖，個案今天也沒有頭痛或視力改變。眼睛偏向左側，有右下臉部下垂，且抬起時右手臂會下垂到床上。個案右耳戴著助聽器，並有數月夜間右手刺痛，去年診斷為腕隧道症候群。生命徵象：血壓178/96 mm Hg（0805重複測量未變，與家中讀數相似），心率88次/分，呼吸頻率18次/分，體溫36.8 C，室內空氣下血氧飽和度96%。床邊血糖118 mg/dL。