A posterior circulation stroke can manifest with a variety of symptoms, including vertigo, ataxia, vomiting, and headache.
Posterior circulation strokes affect the brainstem, cerebellum, and posterior cerebral hemispheres, leading to diverse neurological signs and symptoms. These symptoms can vary widely depending on the specific area of the brain affected.
Key Symptoms of Posterior Circulation Stroke
Symptoms of a posterior circulation stroke are often distinct from those of strokes affecting the anterior circulation and can include issues with balance, vision, consciousness, and cranial nerve functions. Some of the common and significant symptoms are:
- Vertigo: A sensation of spinning or feeling off-balance, often accompanied by nausea.
- Ataxia: Difficulty with coordination, leading to unsteady walking, clumsiness, or problems with fine motor skills.
- Vomiting: Nausea and emesis, which can occur with or without other gastrointestinal symptoms.
- Headache: Pain in the head, which can vary in intensity and location.
- Cranial Nerve Abnormalities: Dysfunction of the cranial nerves, which can lead to problems with eye movements, facial weakness, difficulty swallowing, or changes in sensation in the face.
- Bilateral Long Tract Neurological Signs: Weakness or sensory changes that affect both sides of the body, indicating damage to the major neural pathways that control motor and sensory functions.
- "Locked-in" Syndrome: A severe condition where a person is fully conscious but completely paralyzed, unable to move or speak, except possibly for vertical eye movements.
- Impaired Consciousness: A reduced level of awareness, which can range from drowsiness and lethargy to stupor or coma.
- Complex Ocular Signs: Various visual disturbances, such as double vision (diplopia), nystagmus (involuntary eye movements), or gaze palsies (difficulty moving eyes in specific directions).
- Cortical Blindness: Complete or partial loss of vision despite the eyes themselves being healthy, due to damage to the visual processing centers in the brain.
Symptom Overview Table
The table below summarizes some key symptoms associated with a posterior circulation stroke:
| Symptom Category | Specific Symptom | Description |
|---|---|---|
| Balance & Motor | Vertigo | Sensation of spinning or dizziness, often accompanied by nausea. |
| Ataxia | Impaired coordination, leading to an unsteady gait, difficulty with balance, and uncoordinated movements. | |
| General Neurological | Headache | Pain in the head, which can range from mild to severe. |
| Vomiting | Nausea and expulsion of stomach contents. | |
| Cranial & Visual | Cranial Nerve Abnormalities | Dysfunction affecting facial sensation, eye movement, swallowing, or speech due to damage to nerves originating from the brainstem. |
| Complex Ocular Signs | Various visual disturbances including double vision, involuntary eye movements (nystagmus), or inability to move eyes in certain directions (gaze palsies). | |
| Cortical Blindness | Loss of vision despite healthy eyes, resulting from damage to the brain's visual cortex. | |
| Consciousness | Impaired Consciousness | Reduced awareness, ranging from drowsiness to stupor or coma. |
| "Locked-in" Syndrome" | A severe state of paralysis where the person is fully conscious but unable to move any part of the body except for vertical eye movements, allowing for limited communication. | |
| Motor & Sensory | Bilateral Long Tract Signs | Neurological deficits such as weakness or sensory loss affecting both sides of the body, indicating damage to major nerve pathways in the brainstem. |
