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A 69-year-old female, with no previous history of cerebrovascular disease, presented with acute onset expressive and receptive dysphasia. Neurological examination revealed dysgraphia in addition to dysphasia with no other neurological deficit. The remainder of the clinical examination was unremarkable. Laboratory investigations revealed a normal full blood picture and normal renal function. Electrocardiogram and chest X-ray were within normal limits. An emergency computed tomography scan of brain did not demonstrate any acute intra-cerebral pathology. Symptoms and signs resolved entirely within 4 h and did not recur, providing the clinical diagnosis of a transient ischaemic attack (TIA).The patient was a non-smoker with no history of diabetes, dyslipidaemia, hypertension or atrial arrhythmia. She did however have documented coronary artery disease, with …

An incidental finding or an unusual cause for a transient ischaemic attack?