James
69, Male

James Clark is a 69 year-old right handed man. He has recently retired from his lifelong office job as a pensions advisor.

He is in the local A&E department having been brought in by London Ambulance Service. He presents with a 2-hour history of right-sided arm and leg weakness and difficulty expressing himself. His wife comments that the right side of his face has drooped. She has had to give the history because of his speech difficulty. He is examined on a trolley in the ‘majors’ part of the Accident and Emergency Department.