What is the most likely diagnosis for an 88-year-old patient who presents with right-side weakness after a fall and has a history of aphasia and noncompliance with hypertension medication?

In this scenario, the patient's presentation is indicative of a left-sided cerebrovascular accident (CVA), also known as a stroke. This conclusion is drawn from the observation of right-side weakness, which typically suggests damage to the left hemisphere of the brain that controls motor function on the opposite side of the body. Additionally, the patient's history of aphasia supports this diagnosis since language functions are primarily housed in the left hemisphere for most individuals.

The link between hypertension and stroke is crucial; noncompliance with antihypertensive medication significantly increases the risk of stroke, particularly ischemic strokes, which occurs when blood flow to a part of the brain is interrupted. While the age of the patient and history of a fall may provide context, the key symptoms—right-sided weakness and aphasia—strongly align with a left-sided CVA diagnosis.

Other potential diagnoses explain different presentations: right-sided CVAs would result in left-sided weakness and possibly other cognitive or perceptual issues rather than aphasia; transient ischemic attacks (TIAs) are shorter events with temporary symptoms and often do not lead to significant deficits; and cerebellar strokes would typically present with balance and coordination problems, rather than unilateral weakness. Thus, the presentation here strongly supports a left