For today’s TR pearl, I’d like to take you back to January 2020, when covid was just a foreign virus and I was a fresh-faced intern, shadowing one of our recent grads, Dr. Sengupta in the cardiac room, along with Dr. Meyers. EMS called in a prenotification for a 63-year-old who was found by her family that morning, unresponsive and with a R-sided facial droop. The last known well was the night prior (approximately 12 hours prior to arrival). She was awake, protecting her airway, but not responding to commands. I was sent with the patient to the scanner, along with the neurology team. CT head and CTA were performed. 

Here is the non-con CT, which seemed unremarkable (based on the patient’s clinical status, everyone was expecting a large bleed). Take a look, and then we’ll move on to the rest of the imaging in the PowerPoint below. 

Now, see below for the big reveal for this case, the answer to the CT head above, and the dope teaching points:

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