75yr old male admitted with complaints of cough with expectoration and right iliac fossa pain and tenderness for one month. He was admitted under surgical care. On admission he was normotensive. After Admission his bp raised to grade 2 hypertension. On detailed examination, the history of slurring of speech, nasal regurgitation, mild limb weakness were present for four days along with that hypertension. This patient was not a known diabetic or hypertensive. Ultrasound abdomen came clean. Upper gastrointestinal scopy showed some stricture in cricopharynx with gastritis but no mass. X ray chest showed nothing significant. Bronchoscopy showed Right vocal cord palsy.
CT brain showed some age relatd changes and white matter ischaemia.
His blood works were clean
what causes nasal regurgitation., speech disturbance, limb weaknesses... was it due to local cricopharynx stricture, vocal cord palsy, white ischaemia respectively or something else.
