A 28 year-old male boxer is brought to the ED complaining of severe pain in the left side of his head and neck radiating from his upper neck to his eye. The pain started that morning while shaving and continued to deteriorate but the patient recalls a vague pain in the left neck for the past several days while working out. The patient also complains of numbness in his right leg and foot and a loud pulsatile tinnitus that started 2 hours ago as his headache intensified. On examination you recognize a left sided ptosis and miosis and a 3/5 force of his right lower extremity. Which of the following is true regarding this patient’s probable diagnosis?

About the Author: Anton Helman

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.