Why did this patient stroke?
Nick, a 63-year-old farmer with a history of paroxysmal AF diagnosed five years ago, presented with sudden-onset vertigo, dysarthria and left-sided cerebellar signs.
He described waking up at night with symptoms of vertigo and veering towards the left when walking, associated with tinnitus, but without hearing loss.
Past medical history was notable for hypertension, hyperlipidaemia and paroxysmal AF with a CHA2DS2-VASc score of 1, for which he was on aspirin 100mg daily.
He also had a history of using celecoxib 200mg intermittently to manage