Brenda Farnett, an 82-year-old right-handed woman, was reviewed in the stroke prevention clinic for a possible TIA. Her past medical history included hypertension, treated hypothyroidism, and diet-controlled type II diabetes. Her medications included ASA, HCTZ, and eltroxin. She was initially referred from her family physician's office for evaluation of an episode of right-sided weakness and numbness, mostly involving the arm, lasting about 15 minutes. Her examination in the clinic showed her to be mildly hypertensive at 150/90, and with a regular pulse at 76. Her neurological examination was normal. Her EKG done that day was normal (sinus rhythm). An urgent carotid ultrasound was arranged and she was started on clopidogrel 75 mg OD, ramipril 2.5 mg OD, and atorvastatin 10 mg OD. On the following morning she awoke with mild right-sided weakness and an inability to speak. Her husband immediately called 911. She was taken to the nearest hospital.