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Images in emergency medicine
Acute neurology in the emergency department
  1. S C Mertes
  1. Correspondence to Dr Stephan Christian Mertes, Emergency Department, Royal Cornwall Hospital, Truro, Cornwall TR1 3LJ, UK; scmertes{at}

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A 66-year-old woman presented with sudden onset tearing interscapular pain 1 h after gentle neck exercises. Over the next 3 h, she developed flaccid left arm and leg paralysis and a left Horner's syndrome. Her initial CT scan revealed no evidence of cerebral ischaemia or aortic/carotid …

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.