A 52-year-old right-handed woman comes to the emergency depart | Surgery collections Videos and quizez 2021

A 52-year-old right-handed woman comes to the emergency department due to speech arrest and right arm weakness. The symptoms began suddenly at breakfast but resolved after about 30 minutes. The patient has a history of relapsing-remitting multiple sclerosis. Three months ago, she was hospitalized due to blurry vision in the left eye, which was treated with corticosteroids and improved after several weeks. The patient's other medical issues include hypertension and hyperlipidemia. She is currently not taking any disease-modifying therapy for her multiple sclerosis. She has a 40-pack-year history of tobacco use. Blood pressure is 170/96 mm Hg, and pulse is 92/min. BMI is 35 kg/m2. There is a mild afferent pupillary defect in the left eye with diminished visual acuity. Noncontrast CT scan of the head is unremarkable.