A 44-year-old white woman presented to the Emergency Department with acute onset of severe vertigo, nausea, vomiting, and severe right frontal headache associated with photophobia, which had started the prior evening. Her symptoms improved slightly after a night of rest, but subsequently worsened again the following morning. She denied any focal weakness, sensory changes, or speech changes. She did endorse significant incoordination and was even involved in a minor motor vehicle collision that day. She denied any significant prior medical or surgical history. She drank alcohol occasionally and smoked one pack of cigarettes per day. She denied illicit drug use. Her mother died of a “brain tumor” (type unknown) and her father died of “heart issues.”
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-Sijie Jason Wang, MD
