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A 70-year-old man developed headache, nausea and slurred speech over 6 hours. 2 hours after the symptoms had started, he developed intermittent cognitive changes and unstable walking, and was brought to the emergency department with a possible stroke. He had no history of neurological disease or other pathology. On examination, his gait was unsteady, with trunk imbalance but no hemiparesis. Cranial nerve function was normal, and funduscopy showed no papilloedema.