Posterior circulation (PC) strokes occur in the arteries that supply blood to the back of the brain. They can cause nausea, dizziness, and visual disturbances.

A stroke occurs due to reduced blood flow in the brain. PC strokes are relatively common. They make up around 20–25% of all ischemic strokes.

The outlook for people who experience a PC stroke is generally better than the outlook for other strokes.

This article details PC stroke symptoms, causes, and risk factors. It also discusses the diagnosis, treatment, and outlook for PC strokes and their complications and prevention.

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PC strokes develop in a network of arteries known as the vertebrobasilar arterial system.

This system supplies blood to large areas of the brain. For this reason, a PC stroke can cause a broader range of symptoms than other strokes.

Some common symptoms of PC stroke include:

  • dizziness
  • vertigo
  • nausea
  • vomiting
  • changes in consciousness
  • problems walking
  • limb weakness on one side of the body
  • weakness or paralysis on the face
  • repetitive and involuntary eye movement
  • difficulty speaking

Because many conditions cause similar symptoms, it can be especially difficult for medical staff to recognize a PC stroke.

Doctors are three times likelier not to recognize a PC stroke than other strokes.

What are the 5 D’s of posterior circulation stroke?

Given the diagnostic challenges of PC strokes, some medical professionals are raising awareness about the signs of this condition.

One such initiative focuses on the “5 D’s” of PC strokes:

  • dizziness
  • diplopia (double vision)
  • dysarthria (speech problems)
  • dysphagia (swallowing problems)
  • dyspraxia (lack of bodily coordination)

These are especially common symptoms that could alert first responders to the presence of a PC stroke.

Learn the first aid of a stroke.

Many conditions can lead to strokes. Some of the more typical causes of PC strokes include:

  • atherosclerosis, which is when the arteries harden or thicken
  • cardioembolisms, which are blood clots that arise from heart problems
  • artery rupture, which may or may not occur from trauma

Less commonly, the following conditions can cause PC strokes:

  • vasculitis
  • fibromuscular dysplasia
  • blood clotting disorders
  • drug use
  • migraine

When a person has a stroke risk factor, they have an elevated risk of stroke. It does not necessarily mean having a stroke is inevitable.

The following are risk factors for stroke:

  • being older
  • being a man
  • being of African descent
  • having certain genetic conditions, such as sickle cell disease
  • having a family history of stroke or similar diseases

One crucial aspect of PC stroke diagnosis is the use of imaging studies. These studies can take the following forms:

  • CT angiography
  • digital subtraction angiography (DSA)
  • MRI scans

Certain blood tests can also be very useful for PC stroke diagnosis. These tests include:

  • complete blood counts
  • complete metabolic panels
  • blood glucose tests

Doctors may also recommend heart monitoring tests to check whether a stroke is due to heart disease.

There are two main phases of PC stroke treatment.

The first phase focuses on treating acute stroke. The goal is to prevent as much brain damage as possible, save the person’s life, and limit disability.

Possible treatment options during this first phase include:

  • intravenous (IV) tissue plasminogen activator medications
  • surgery to remove any blood clots
  • surgery to widen any narrowed arteries

The second phase focuses on preventing further strokes. This may involve taking medications, such as antiplatelet or anticoagulation drugs. Doctors may also recommend lifestyle strategies, like diet and exercise.

If a stroke causes long-term disability, a person may require rehabilitation. Depending on the severity of the disability, this process could take several months.

Strokes are very serious and a leading cause of disability. Strokes are the fifth most common cause of death in the United States.

PC strokes can also cause significant disability or death. However, PC strokes are less likely to have these effects than other types of strokes.

It is impossible to eliminate the risk of stroke. However, some stroke risk factors are modifiable.

People can lower their risk of stroke by:

  • not smoking
  • avoiding or limiting alcohol
  • getting regular exercise
  • eating a nutrient-dense diet
  • managing blood pressure
  • managing atrial fibrillation (AFib), if applicable
  • managing diabetes, if applicable

PC strokes can deprive large areas of the brain of oxygen. This can cause widespread brain damage.

Partly for this reason, and partly because PC strokes can cause extensive hospitalization or disability, these strokes have many potential complications, such as:

Strokes are medical emergencies that can cause death or significant disability. Early treatment could save a person’s life and reduce brain damage from a stroke.

The Centers for Disease Control and Prevention (CDC) recommends that anyone with stroke symptoms immediately call 911 or go to the nearest emergency room.

PC strokes begin in the vertebrobasilar arterial system. This network of blood vessels supplies blood to the back of the brain, including many areas around the spinal cord. It is very common for strokes to affect this part of the brain.

Because PC strokes can cause extensive brain damage, they manifest in many ways. In particular, PC strokes do not always cause the “stereotypical” signs of stroke, such as weakness on one side of the body.

While PC strokes can be serious, the outlook for someone with a PC stroke is better than other types of strokes.