POSSIBLE MORE THAN ONE EPISODE OF BRAIN STROKE/RIGHT SIDE OF THE BODY LIKE PARALYSIS/WEIRD TYPE WALK/EXTREME DIZZINESS/BAD HEADACHE OVER TOP LEFT SIDE/UNBEARABLE HEADACHE; BLOOD PRESSURE SPIKE DIASTOLIC; BURNING PAIN SENSATION BEHIND NOSE BRIDGE; LEFT SIDED VOCAL CORD PARALYSIS/VOICE CHANGE; PAIN BEHIND LEFT EYE; ARRHYTHMIA; This spontaneous report received from a patient concerned a 60 year old male. The initial information was processed along with additional information received from the patient on 10-AUG-2021. The patient's height, and weight were not reported. The patient's past medical history included: triple bypass open heart surgery (3 years ago), and concurrent conditions included: non-alcohol user, nonsmoker, and pulmonary embolism, and other pre-existing medical conditions included: The patient had no known allergies. The patient had no history of drug abuse/illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and expiry: UNKNOWN) dose was not reported, 1 total administered on 02-JUN-2021 for prophylactic vaccination.  The concomitant medications included rivaroxaban (Xarelto).  The patient had no side effects after vaccination between 2-JUN-2021 and 22-JUN-2021. On 23-JUN-2021, the patient experienced burning pain sensation behind the bridge of nose and then extended into pain behind the left eye. The patient had bad headache over the top left side of the head and it was accompanied with very extreme dizziness. The patient also experienced voice change. The blood pressure had spiked up to 200 diastolic (that the patient had never experienced before and his blood pressure was usually normal). The duration of the symptoms lasted for 2 hours. On 25-JUN-2021, the patient had same symptoms and lasted for 3 to 7 hours and it was intense than before. The patient went to emergency room(ER)for the symptoms as he felt like a brain stroke or hemorrhage due to his symptoms. The patient had undergone CT (computed tomography) scan and nothing found on testing. On 26-JUN-2021 and 27-JUN-2021, the patient had same symptoms. On 28-JUN-2021, the patient had very bad symptoms and went back to the ER. The ER doctor recommended the patient to consult with ENT. On 01-JUL-2021, the patient consulted with ENT and doctor stated the patient had not experienced symptoms due to vertigo. As the doctor identified the patient had left sided vocal cords paralysis. The ENT referred the patient to neurologist. The Patient was told by the neurologist, to have CT scan with a contrast and MRI (magnetic image resonance) if nothing showed up in CT scan. On MRI it showed that patient had occlusion in left vertebral artery, and the right vertebral artery was clear. On 2-JUL-2021, the neurologist explained that it might be possible that the patient might have over more than 1 episode of brain strokes, and the machine might have not detected. The patient was also advised to maintain cholesterol level below 70. On 03-JUL-2021, the patient had experienced same symptoms. On 4-JUL-2021, the patient had severe symptoms with unbearable headache, diastolic blood pressure200-220(felt like going to explode from the inside). The patient was hospitalized upon ER doctor decision. The patient was ordered for X-ray of heart and echo of the heart and which all came out good. On 05-JUL-2021 to 06-JUL-2021, the patient had worst episode of symptoms and was transferred in the middle of night to the ICU (intensive care unit) The blood pressure was 240/113mmHg and the hospital gave medication for BP then, the patient experienced arrhythmia. At the time of reporting the patient's symptoms are not worse but the BP only goes up to 169-175. The patient had dizziness and voice changes (still get vocal cord paralysis) along with that, the patient stated 3 episodes of symptoms per day which last only for 5 minutes. The patient also stated all of his symptoms are slowly fading in terms of intensity and duration. The cardiologist told the patient that his symptoms was not related to heart. The patient consulted almost 8 to 10 doctors (internal medicine, ER doctors, neurologists, and ENT) and had 4 CT scans and 3 MRIs to look for bleeding or hemorrhage and brain stroke. The patient was referred to another hospital on January or February 2022 for consultation with radiologists. The patient has an upcoming MRI imaging to be done. The Patient reported another episode of dizziness while reporting and decided to end the call when asked if patient was okay to continue with the conversation.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from burning pain sensation behind nose bridge, blood pressure spike diastolic, and pain behind left eye, had not recovered from left sided vocal cord paralysis/voice change, and possible more than one episode of brain stroke/right side of the body like paralysis/weird type walk/extreme dizziness/bad headache over top left side/unbearable headache, and the outcome of arrhythmia was not reported. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender's Comments: V0: 20210820232-COVID-19 VACCINE AD26.COV2.S. ARRHYTHMIA, POSSIBLE MORE THAN ONE EPISODE OF BRAIN STROKE/RIGHT SIDE OF THE BODY LIKE PARALYSIS/WEIRD TYPE WALK/EXTREME DIZZINESS/BAD HEADACHE OVER TOP LEFT SIDE/UNBEARABLE HEADACHE. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: MEDICAL HISTORY 20210820232-COVID-19 VACCINE AD26.COV2.S. BLOOD PRESSURE SPIKE DIASTOLIC, BURNING PAIN SENSATION BEHIND NOSE BRIDGE, LEFT SIDED VOCAL CORD PARALYSIS/VOICE CHANGE, . This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.