An 83-year-old woman presented to the emergency department with a 2-day history of persistent vertigo. She also complained of neck pain, lightheadedness, nausea, and vomiting. She had hypertension and had undergone balloon angioplasty for stable angina pectoris 1 month prior. Her medications included enalapril, bisoprolol, aspirin, prasugrel, rosuvastatin, and torsemide. Physical examination revealed that she was afebrile, alert, and oriented. Her gait was wobbly and deviated toward the right. Direction-fixed horizontal nystagmus beating toward the left was noted.
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