A 67-year-old man is brought into the accident and emergency department by ambulance with new left-sided limb weakness and a left facial droop. This started 40 minutes earlier while the patient was drinking in his local pub. Complaining of dizziness for a short while, the patient suddenly fell from his bar stool. An attendant managed to help him to an armchair and noticed that he was slurring his words and could not use his left arm to help himself up. An ambulance was called, and during this time the patient developed a left-sided facial droop.
He remained alert throughout but appeared anxious and disorientated. The patient is known to the hospital and has attended previously with attacks of angina. There is no history of myocardial infarction, but he is on tablets for hypertension and dyslipidemia. He is a smoker and lives at home with his wife. There have been no recent intercurrent…
