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The NeuroBowl-Neurology Today Case Challenge
Hypertensive Smoker with Left-sided Weakness
Solve this Case!


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A 57-year old man with a history of hypertension and smoking had a two- hour history of left-sided weakness and numbness. In the emergency department, his blood pressure was 260/130 and he suddenly became less responsive. His eyes were skewed. There was no movement of the right eye; the left eye was able to abduct only. His left arm and leg were weak.

Where would you localize this? See the images below for guidance. What tracts/nuclei were lesioned to produce these ocular findings in this patient?”

Send your findings to [email protected]. In the subject line, please write NeuroBowl-Neurology Today Case Challenge, and in the email, include your answer and how you arrived at it. Please include your name, title, and location. We'll publish the answer and our respondents' answers in an upcoming issue of Neurology Today.

Dr. Patel is a neurology resident at the Medical College of Georgia.