A 5-Year-Old Boy Is Brought to the Emergency Department Due

A 5-year-old boy is brought to the emergency department due to right-sided hemiplegia.  His parents say that he has been having increasing difficulty moving his right arm and leg over the past 3 hours.  This morning, approximately 10 hours prior, the child tripped on a toy while brushing his teeth and fell forward with the toothbrush in his mouth.  He cried immediately, but his parents did not note any oral bleeding.  The boy did say, "My throat hurts" throughout the day but was able to eat his lunch.  The child has a history of attention deficit hyperactivity disorder for which he takes methylphenidate.  The boy's mother has a history of migraines, and his grandfather had a stroke at age 62.  Neurologic examination shows right hemiplegia, right hemianesthesia, and mild motor aphasia.  Which of the following is the most likely cause of this patient's condition?

A) Antithrombin III deficiency
B) Arteriovenous malformation
C) Carotid artery dissection
D) Congenital heart disease
E) Focal seizure
F) Hemiplegic migraine
G) Homocystinuria
H) Retropharyngeal abscess

Correct Answer:

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