Congenital anomaly of the posterior arch of the atlas: a rare risk factor for posterior circulation stroke

We report an extremely rare case involving a posterior arch anomaly of the atlas, causing a vertebral artery dissection (VAD) induced posterior circulation stroke. A 16-year-old girl was admitted to hospital because of new onset dizziness. VAD related multiple infarction in the posterior circulation was revealed. The congenital posterior arch anomaly of the atlas, along with instability of the atlantoaxial joint, were discovered accidentally during follow-up. This is the first case of ischemic stroke related to atlantal posterior arch aplasia and atlantoaxial instability. Although rare, it reminds us that investigation of the craniovertebral junction should be considered when stroke occurs in young patients.

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POSTERIOR CIRCULATION STROKE IN CHILDHOOD: RISK FACTORS AND OUTCOME

Neuropediatrics ◽

10.1055/s-2006-945717 ◽

2006 ◽

Vol 37 (S 1) ◽

Author(s):

HA Arroyo ◽

MC Buompadre ◽

A Ceciliano

Keyword(s):

Risk Factors ◽

Posterior Circulation ◽

Posterior Circulation Stroke ◽

Childhood Risk Factors

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CENTRAL HYPOVENTILATION SYNDROME FOLLOWING POSTERIOR CIRCULATION STROKE

10.26226/morressier.5ab8f55ad462b8029238d436 ◽

2018 ◽

Author(s):

May Nwe

Keyword(s):

Posterior Circulation ◽

Posterior Circulation Stroke ◽

Central Hypoventilation ◽

Hypoventilation Syndrome

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Posterior circulation stroke: an easily overlooked complication of catheter ablation of atrial fibrillation

BMJ Case Reports ◽

10.1136/bcr-2020-234661 ◽

2020 ◽

Vol 13 (8) ◽

pp. e234661

Author(s):

Tahir Nazir ◽

Mohiuddin Sharief ◽

James Farthing ◽

Irfan M Ahmed

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Treatment Options ◽

Posterior Circulation ◽

Diagnosis And Treatment ◽

Neurological Deficits ◽

Cerebellar Infarction ◽

Af Ablation ◽

Posterior Circulation Stroke ◽

Ventricular Response

Catheter ablation of atrial fibrillation (AF) has established itself as a safe and proven rhythm control strategy for selected patients with AF over the past decade. Thromboembolic complications of catheter ablation are becoming rare in anticoagulated patients with a risk of stroke reported as 0.3%. A particular challenge is posed by clinical presentation due to ischaemic stroke involving the posterior circulation following catheter ablation because of its substantial differences from the carotid territory stroke, making the timely diagnosis and treatment very difficult. It is crucial to keep an index of clinical suspicion in patients presenting with neurological deficits related to vertebrobasilar circulation following ablation. We describe the case of a man who presented with dizziness and palpitations after radiofrequency catheter ablation of AF. He was found to be in AF with a rapid ventricular response. His dizziness was initially attributed to the cardiac dysrhythmia. As his symptoms continued despite heart rate control, he underwent further investigations and was eventually diagnosed with a posterior circulation stroke resulting in left cerebellar infarction. He was treated with antiplatelet therapy and improved significantly over the following few days. We review and present an up-to-date brief literature review on the complications of catheter ablation of AF and describe pathophysiology, clinical features, diagnosis and treatment options for posterior circulation stroke after AF ablation. This case aims to raise awareness among clinicians about posterior circulation stroke after AF ablation.

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An Attempt to Define Mechanical Thrombectomy in Posterior Circulation Stroke: Insights from STAR

World Neurosurgery ◽

10.1016/j.wneu.2021.01.106 ◽

2021 ◽

Vol 147 ◽

pp. 215-216

Author(s):

Mithun G. Sattur ◽

Ali M. Alawieh ◽

Alejandro M. Spiotta

Keyword(s):

Mechanical Thrombectomy ◽

Posterior Circulation ◽

Posterior Circulation Stroke

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APICAL PLEURAL ASPERGILLOSIS WITH PANCOAST'S SYNDROME AND POSTERIOR CIRCULATION STROKE: A CASE REPORT

Journal de Mycologie Médicale ◽

10.1016/j.mycmed.2021.101154 ◽

2021 ◽

pp. 101154

Author(s):

Y Muralidhar Reddy ◽

Subhendu Parida ◽

Premchand Gupta ◽

Shyam K Jaiswal ◽

Ganjisreenivasa Gnaneswar ◽

...

Keyword(s):

Case Report ◽

Posterior Circulation ◽

Posterior Circulation Stroke

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Intravenous thrombolysis outcome in posterior vs anterior circulation stroke in a tertiary stroke center in Egypt

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00325-0 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Nourhan Abdelmohsen Taha ◽

Hala El Khawas ◽

Mohamed Amir Tork ◽

Tamer M. Roushdy

Keyword(s):

Intravenous Thrombolysis ◽

Posterior Circulation ◽

University Hospitals ◽

Stroke Patients ◽

Anterior Circulation ◽

Time Points ◽

Posterior Circulation Stroke ◽

First Line Therapy ◽

Insignificant Difference ◽

Stroke Center

Abstract Background Intravenous thrombolysis (IVT) with alteplase is the first-line therapy for acute ischemic anterior and posterior circulation strokes (ACS and PCS). Knowledge about safety and efficacy of IVT in posterior circulation stroke is deficient as most of the Egyptian studies either assessed IVT outcome in comparison to conservative therapy or its outcome in anterior circulation stroke only. Therefore, our aim was to compare the relative frequency and outcome after intravenous thrombolysis in anterior versus posterior circulation stroke patients presenting to stroke centers of Ain Shams University hospitals (ASUH). Results A total of 238 anterior circulation stroke and 61 posterior circulation strokes were enrolled, onset-to-door and door-to-needle time were statistically insignificant. NIHSS showed comparable difference at all time points despite higher scores along anterior circulation stroke; 90-day modified Rankin Scale (mRS) showed significant improvement in both groups from mRS >2 to ≤2 with a better percentage along posterior circulation stroke patients. There was insignificant difference for either incidence of death or intracranial hemorrhage (ICH) between the two groups. Conclusion IVT significantly reduced NIHSS for both anterior and posterior circulation stroke along different studied time points. Meanwhile, a higher percentage of patients with posterior circulation stroke had a better mRS outcome at 90 days.

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