Abstract
20% of ischemic strokes involve posterior circulation. The most common causes of posterior circulation large artery ischemia are atherosclerosis, embolism, and dissection. The most common location of atherosclerotic occlusive disease within the posterior circulation is the proximal portion of the vertebral artery in the neck within the first inches. Basilar artery occlusive disease most often presents as ischemia in the pons. Occlusion of the rostral portion of the basilar artery can cause ischemia of the midbrain, thalami, temporal, and occipital lobe. The most frequent finding in patients with PCA territory infarction is a hemianopia.
Highlights
Stroke is the second most common cause of mortality and morbidity, the incidence of stroke due to ischemia is 68%, while of hemorrhagic stroke is 32%, reflecting a higher incidence of hemorrhagic stroke in low- and middle-income countries. 20% of ischemic strokes in the brain involve posterior circulation structures
Basilar artery occlusive disease most often presents as ischemia in the pons
This case study may help in early recognition of this type of stroke presenting with triad of bulbar symptoms, quadriparesis and respiratory failure
Summary
Bilateral medial medullary stroke is very rare type of posterior circulation stroke that presented with clinical trial of sudden onset of bulbar signs and symptoms, quadriparesis and respiratory failure. Of patient with bilateral medial medullary stroke who survivors remained dependent
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