You have arrived on the scene of a call for a possible stroke. On your arrival, the patient denies signs and symptoms, is alert and oriented. Her husband states that before you arrived, the patient could not move her right arm and the left side of her face seemed to be "slack." Which of the following has most likely occurred?

The scenario describes a situation where the patient initially exhibited signs of a stroke, such as facial droop and inability to move her right arm. However, upon the assessment by emergency personnel, she is alert, oriented, and denies current symptoms. This pattern is consistent with a transient ischemic attack (TIA), which is often referred to as a "mini-stroke."

During a TIA, blood flow to the brain is temporarily interrupted, leading to stroke-like symptoms that resolve completely within a short period, usually less than 24 hours. The fact that the patient is now symptom-free and oriented suggests that whatever neurological deficit she experienced was transient.

In contrast, a full stroke would typically result in lasting deficits or changes in consciousness, which are not present in this case. A subarachnoid hemorrhage involves bleeding in the area between the brain and the tissues covering it, often accompanied by severe headaches or loss of consciousness, which are not described here. Aphasia refers specifically to language impairment and would not account for the motor deficits observed in the patient’s arm and facial mobility.

Thus, the transient nature of the symptoms is the key indicator that a transient ischemic attack has most likely occurred.