Posterior circulation stroke: clinical features

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Posterior circulation stroke: clinical features. This accounts for 20% of strokes. Fully referenced neurology checklist.

Epidemiology

  • This accounts for 20% of strokes
  • It has a high risk of multiple transient ischaemic attacks (TIAs) at presentation
  • It also has a high risk of recurrent stroke
  • Mortality is high if there is ≥50% stenosis of the vertebrobasilar vessels

Features of impaired consciousness

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Features of impaired vegetative functions

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Features of weakness

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Unusual features

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Specific posterior circulation stroke syndromes

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Red flag presentations

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Difficulties with clinical diagnosis

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Complications

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References

  1. Markus H, Van der Worp HB, Rothwell PM. Posterior circulation ischemic stroke and transient ischemic attack: diagnosis, investigation, and secondary prevention. Lancet Neurol 2013; 12:989-998.
  2. Marquardt L, Kuker W, Chandratheva A, Geraghty O, Rothwell PM. Incidence and prognosis of >50% symptomatic vertebral or basilar artery stenosis: prospective population-based study. Brain 2009; 232:982-988.
  3. Sairanen T, Strbian D, Soinne L, et al. Intravenous thrombolysis of basilar artery occlusion: predictors of recanalization and outcome. Stroke 2011; 42:2175-2179.
  4. Cloud CG, Markus HS. Diagnosis and management of vertebral artery stenosis. Q J Med 2003; 96:27-54.
  5. Benke T, Bodner T, Wiesen D, Karnath HO. The amnestic syndrome of posterior cerebral artery infarction. Eur J Neurol 2022; 29:2987-2995.
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