Clinical Profile of Posterior Circulation Stroke

Background: The vascular territory associated with posterior circulation supplies a compact region of the brain which controls vital body functions, hence a stroke in this area can lead to significant morbidity and mortality. Due to overlapping symptomatology, it is oftenmisdiagnosed as a peripheral cause of vertigo. Our study was aimed at studying the risk factors, symptomatology, anatomical localisation, artery involved, and outcomes related to posterior circulation stroke (PCS). We believe this study can lead to earlier diagnosis and prompt management which is very crucial in deciding outcomes of posterior circulation strokes. Methods: A tertiary care hospital-based cross-sectional time bound study was conducted among patients attending OPD or admitted in ward in from September 2021 to October 2022 meeting the inclusion-exclusion criteria. 43 patients admitted with PCS under departments of General Medicine and Neurology in Kasturba Hospital, Manipal were analysed for the study. Results: 22 patients were older than 65 years. 14 were aged 45 to 65 years. 28 were males. Among risk factors, diabetes and hypertension were found to be present in 23 and 21 patients, respectively. 21 subjects had significant smoking history. 26 subjects presented with ataxia or vertigo. 26 subjects had cerebellar signs on examination. Vertebral artery and posterior cerebral artery were the most common implicated vessel (12 and 6 subjects respectively). As per TOAST classification, small artery type was found in 14 subjects and large artery stroke was present in 11 subjects. Conclusions: Diabetes mellitus was the most common risk factor for PCS in our study followed by hypertension. Ataxia and vertigo were the most common presenting features of PCS in the present study. Cerebellum was the most common anatomical area involved. In our study, vertebral artery was most commonly affected. Small vessel disease was the main aetiological factor followed by large vessel disease.