A 65-year-old male with a history of hypertension presents with sudden onset of difficulty swallowing and hoarseness. He also complains of dizziness and unsteady gait. On examination, he has a hoarse voice, decreased gag reflex, and loss of temperature sensation on the right side of the face and left side of the body. What is your primary concern and what would be the next step?
This patient's symptoms suggest a type of stroke known as lateral medullary syndrome or Wallenberg's syndrome, which involves the medulla of the brainstem. Immediate actions should include stabilizing the patient, followed by neuroimaging with a CT scan and possibly an MRI to confirm the diagnosis.