A 66-Year-Old Man Is Evaluated in the Emergency Department Due

A 66-year-old man is evaluated in the emergency department due to weakness and loss of speech. The patient is known to have hypertension and diabetes Mellitus. He has been smoking 1 pack of cigarettes for the last 30 years. The wife was waking him up when she found him unable to speak or move. Physical examination shows a normal pupillary response. The horizontal eye movements are impaired, with an intact vertical gaze. There is a loss of the motor power of the four extremities. A lesion in which of the following sites would explain the patient's symptoms?

A) Angular gyrus
B) Cingulate gyrus
C) Ventral midbrain
D) Ventral pons
E) Medial medulla
F) Lateral medulla

Correct Answer:

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