This case involves a sixty-two-year-old male who underwent a pain management procedure for chronic lumbar radiculopathy with associated lumbar disc herniation. The procedure was a fluoroscopically guided, contrast controlled left L5 and S1 transforaminal epidural steroid injection with epidurogram done under local anesthesia plus IV sedation. The pre-operative notes reflect that the patient had a blood pressure over 200 on several readings, but the physician still chose to conduct the procedure. The procedure was performed uneventfully and the operative notes make no mention of any difficulty. Shortly after, however, the patient displayed stroke-like symptoms in the recovery room. A CAT scan performed after surgery showed a right internal capsule lacunar infarct with a subtle area of low attenuation.