A 61-year-old African-American woman with a history of poorly controlled arterial hypertension was evaluated because of acute onset of left hemibody numbness. Her blood pressure was 204/100 mm Hg.

Acute stroke is one of the leading causes of morbidity and mortality in the world. The World Health Organization estimates that approximately 15 million new strokes occur each year worldwide. Stroke is a clinical diagnosis that requires prompt diagnostic treatment. Differentiation between brain infarction and hemorrhage is paramount. In the Western world, of all strokes, 87% are ischemic. Hemorrhagic strokes account for the remaining. A thorough history and physical examination are essential in guiding a rational and cost-effective management.