Dr. Clif CleavelandLast year in a Southern city, a middle-aged man experienced stomach cramps, diarrhea and lightheadedness for three days. Upon standing from a seated position, he briefly fainted, striking his forehead on the floor.
No seizure activity was observed by his wife, who estimated that he was unconscious for a few seconds before becoming fully alert. His wife drove him to a nearby emergency room.
His prior medical history was unremarkable. He took no medications and had no prior symptoms to suggest heart or nervous system problems.
On examination, he had a small cut on his nose and an abrasion on his forehead. His blood pressure dropped when he sat up. His lab studies suggested dehydration for which IV fluids were initiated. He was admitted to an intensive care unit.
Over the next 18 hours he had CT scans of his face, brain and chest. An MRI scan with and without vascular contrast was obtained of head and neck along with an ultrasound study of the arteries in his neck. An electroencephalogram was obtained following a consultation by a neurologist. All studies were normal.