Teaching Case: Right PCA Stroke – CT Perfusion Identifies Penumbra After Normal Non-Contrast CT

A 49-year-old with left homonymous hemianopsia had an unremarkable non-contrast head CT. CT perfusion revealed right PCA territory penumbra (Tmax mismatch), and CTA confirmed a focal P1-P2 junction occlusion. Post-treatment MRI showed a small right hippocampal infarct.

• Illustrates the added value of CT perfusion and CTA in acute posterior circulation stroke when non-contrast CT is normal.
• Single educational case; not a research study. Part of a series on stroke imaging.
• Intended for radiology trainees and those learning neuroimaging interpretation.

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