Patient also denies any history of seizures, swallowing difficulty, hoarseness, hearing changes, tinnitus, transient neurological symptoms, difficulty walking.
Patient does have mild global headaches, but no nausea or vomiting, no neck pain or stiffness.
She denies diabetes mellitus, heart disease, cigarette smoking, lung or other GI disease. 99 Patient is in good general medical condition. She is awake and alert and in no apparent distress. Also noticeable are cafe au lait spots. Auscultation of the neck elicits a very loud bruit in the region of the left carotid.