His past medical history includes hypertension for which he takes medication, and 2 years ago he had a large myocardial infarction. At that time he spent several weeks in the cardiac care unit and has not been able to return to his job as a construction supervisor. On physical exam, he is an overweight man who appears confused and cannot express himself verbally. His neck is supple. He has mild weakness of his right arm.
Pupils are round, reactive, and slightly unequal in size.
To evaluate his neurologic disease, you order a CT scan which is performed approximately 3 hours after onset of symptoms. Describe the location and shape of any abnormalities . Middle cerebral artery. Not really for the neurologic evaluation. Further tests may be indicated to evaluate his cardiac or renal function, since these organs are also affected by his underlying ischemic heart disease and hypertension.