Abstract

Posterior circulation stroke (PCS) involving the vertebrobasilar system constitutes about 20% of ischemic strokes. Unlike anterior strokes, PCS often presents with non-specific symptoms such as dizziness, vomiting, and visual disturbances, leading to frequent misdiagnosis and treatment delay. Owing to its distinct vascular anatomy and varied presentation, integrated clinical and radiological evaluation is vital for early diagnosis and management.
Objectives: To assess the clinical patterns and risk factors associated with posterior circulation stroke in patients presenting to a tertiary care hospital.
Methods: A prospective cross-sectional study was conducted over 18 months at Al-Ameen Medical College Hospital, Vijayapur, including 100 confirmed cases of PCS. Data were obtained through structured clinical evaluation, laboratory testing, and neuroimaging. MRI and MRA confirmed the diagnosis and vascular localization. Clinical features, risk factors, and arterial territories were analyzed using SPSS version 26.
Results: The mean age was 55.2 ± 12.3 years, with males comprising 63%. Hypertension (61%) was the most common risk factor, followed by smoking (27%), dyslipidemia (24%), alcohol use (23%), and diabetes (18%). The leading symptoms were giddiness/vomiting (58%), motor weakness (47%), cranial nerve deficits (38%), cerebellar signs (28%), and visual field defects (24%). Radiologically, the posterior cerebral artery (47%) and posterior inferior cerebellar artery (45%) were most frequently involved, followed by the superior cerebellar (20%) and basilar (17%) arteries.
Conclusion: PCS predominantly affects males over 50 years and is strongly linked to hypertension and smoking. Presentations are often non-specific, requiring high clinical suspicion. MRI plays a key role in diagnosis. Early detection and targeted management based on vascular involvement and risk factors can enhance patient outcomes.

Keywords

posterior circulation stroke, vertebrobasilar stroke, ischemic stroke, MRI, cerebellar infarct, basilar artery, giddiness, hypertension