Is it the Heart or the Brain?

A 66 year old gentleman was brought to the Accident and Emergency department after he was found unconscious in the toilet. He had new ECG changes. An urgent CT scan showed no haemorrhage, infarction or space-occupying lesion. The patient was initially treated as a case of acute coronary syndrome. The troponin level 12 hours after the episode was normal. Consciousness gradually improved and further neurological examination revealed gait ataxia with right sided deviation. MRI scan of the brain showed a large acute cerebellar infarct. The patient improved with the standard treatment regimen for stroke and made a good recovery.