Make the Diagnosis: Vertigo and Wide Pulse Pressure

(MedPage Today) -- Case Findings: A 24-year-old man with minimal medical history presents with a few notable findings on exam: Ten days of episodic vertigo, which is provoked by extending his head and turning it to the right. It lasts for a few minutes, but resolves without lightheadedness, imbalance, or pre-syncope. He has not had any trauma to the head or neck and is otherwise feeling well. He did, however, respond positively to a Dix-Hallpike test. Widened pulse pressures with an initial blood pressure of 170/58 mmHg. A second measurement resulted in pressures of 142/64 mmHg in the right arm and 138/54 mmHg in the left arm. His medical record indicated that his pressure was 158/60 mmHg a year earlier. He claims that he has never had any cardiopulmonary concerns during childhood. What is your diagnosis?
Source: MedPage Today Neurology - Category: Neurology Source Type: news