Sudden Severe Vertigo in Medicine / Internal Medicine — 72yo Man | Neurology | SMLE Q#18283

SMLE Question #18283

Medicine / Internal Medicine Neurology

Objective: OBJ-NEURO-STROKE-POSTCIRC

Last updated: February 2026
A 72-year-old man with long-standing hypertension presents with sudden severe vertigo, nausea, dysphagia, and persistent hiccups that began 2 hours ago. Neurologic examination shows ipsilateral limb ataxia, ipsilateral loss of facial pain and temperature sensation, ipsilateral partial ptosis and miosis, and contralateral loss of pain and temperature sensation in the body. Motor strength is preserved. Which cerebral circulation vessel is most likely affected?

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