Subclavian Steal Syndrome, Cerebellar Infarctions, and Alcohol

A 74-year-old non-smoker man with a history of hypertension, dyslipidemia and old myocardial infarction, presented with vertigo and vomiting developing after dinner with vodka consumption (200 gr). Nystagmus, associated with right cerebellar signs, ataxia and mild right hemiparesis and pyramidal signs were found. Asymmetric radial pulses and blood pressure were noted on admission (140/80 right, 110/70 left). Otherwise, examination, laboratory tests, ECG, and echocardiography were unremarkable.