6.1.1 Headache attributed to ischaemic stroke (cerebral infarction)

Identification: Male patient, 58 years old, with a history of hypertension and diabetes, and a 30-year history of smoking. Clinical History: The patient presented to the emergency department with a complaint of a severe headache of sudden onset 2 hours prior, described as "the worst headache of his life." He also reported weakness on the right side of the body and difficulty speaking. He denied head trauma, fever, or recent infections. He reports irregular use of antihypertensives and hypoglycemic agents. Physical Examination: Neurological: Right hemiparesis (strength 2/5), expressive aphasia, conjugate gaze deviation to the left. Other findings: Blood pressure: 190/110 mmHg; heart rate: 92 bpm; no meningeal signs. Complementary Exams: Non-contrast cranial Computed Tomography (CT): Acute hypodensity in the left middle cerebral artery territory, suggestive of acute cerebral infarction. Cranial Magnetic Resonance Imaging (MRI): Confirmed area of acute ischemia in the left middle cerebral artery territory. CT Angiography: Occlusion of the left middle cerebral artery. Laboratory: Blood glucose of 280 mg/dL, complete blood count and coagulation profile within normal parameters.