A 71-year-old man had NPC received radiation
therapy (RT) 26 years ago. He had a habit of cigarette
smoking for 30 years or more and alcohol drinking for
about 10 years. He was noted to have hypertension 10
years ago but he did not regular take medication to control
blood pressure. He suffered from an acute onset of slurred
speech and unsteady gait with left neck pain. He did not
pay attention to it. Tarry stool occurred three days later
and he was sent to our emergency room.
On examination, his blood pressure was 176/91
mmHg. There was mild left facial palsy with dysarthria
and dysphagia. The muscle power of his left limbs was
grade 4/5 (Medical Research Council of Great Britain).