This directed case study tells the story of a middle-aged man with hypertension and hyperlipidemia who experiences an ischemic cerebrovascular accident. The case provides an opportunity for students to integrate the brain's functional anatomy related to control of speech and body movement, and to examine how disruption of the brain's blood supply can have systemic effects. Students learn the anatomy of the brain's blood supply and explore the neural integration of upper motor neurons in the quadriceps reflex. Group discussion is used to teach the post-stroke symptoms of hemiparesis (primarily in the lower extremity), dysphasia, and alien hand syndrome. The case was originally developed for upper-level undergraduate biology majors following their coursework in anatomy, physiology, and neuroscience. The case is also appropriate for any upper-level college undergraduate or graduate course that covers the cardiovascular system, structure and function of the brain's cerebrum, and the brain's blood supply (circle of Willis and the general supply of each cerebral artery).