The man with the evolving stroke
| This 69 year old black male was admitted with a chief complaint of vertigo and ataxia. Three days before admission he bean to feel vertiginous and his gait became slightly ataxic. His vertigo worsened and, on the day before admission, he began to complain of diplopia and left ear tinnitus. When he became dysarthric and his ataxia worsened on the following day, he came to the StonyBrook ER. On examination, he had a right medical rectus paresis. There was gaze-directed nystagmus in a lateral direction and rotary nystagmus when he looked up. There was decreased appreciation of light touch and pin-prick sensation on the left V1-V3 distributions and a paresis of both the upper and lower portions of his right face. The right palate did not elevate, and the uvula deviated to the left. He had severe dysarthria. He was ataxic with a wide-based gait and dysmetria on left finger-to-nose testing. He had a past medical history of hypertension, diabetes, and previous strokes.
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Last updated by Webmaster on August 18, 2009
