A 70 year old Afro-Caribbean man presented with sudden onset of neck pain and the subsequent development of progressive right sided weakness and numbness in his right leg. On examination he was an obese man with a blood pressure of 234/136 mm Hg while lying down. The patient's Glasgow Coma Score was 15. He had grade 4/5 power in his right arm and grade 3/5 in his right leg. Fine touch sensation was reduced in his right leg. It was painful to move his neck in all directions and the range of movement was reduced. Plain films of the neck showed degenerative change, without evidence of malignancy. Baseline blood analyses, including …