Systemic disease: Vascular disorders with neurological consequence

Many neurological disorders have underlying vascular complications as the cause. Here are three cases from practice which, though rare, might present in primary care practice.

In July 2009 patient CW, aged 63, a very fit man who ran marathons decided to go for a long run. Prior to the run he did some vigorous shoulder exercises and felt dizzy and experienced vertigo-like symptoms. He decided to lie down and went to sleep. On awakening he could not move his right arm and he could not stand up at all. He also found he lost his balance and was falling towards the right side. Losing his mobility, he became bed-ridden for a couple of days.