Case presentation:
A 43-year-old man presented to our emergency department with a history of impaired mentation, weakness of the left side of the body and unable to speak for 5 hours with a past medical background of poorly controlled hypertension. On examination his pulse rate was 46/ min, blood pressure was 220/120 mm of Hg and Glasgow coma scale of 10/15(E2V3M5). Bilateral pupils were equal in size with preserved pupillary response to the light. Detailed examination revealed findings in accordance with history. He had left sided weakness with decreased power(0/5), absent deep tendon reflexes in the left upper and lower extremity with extensor plantar response in left lower limb. He had no history of diabetes, trauma, drug abuse and anticoagulant medication use.