Difficulties in Diagnosing Posterior Circulation Stroke: A Clinical and Radiological Correlation in Emergency Department and its Implication from Blood Pressure Management

Posterior circulation stroke makes up 30% of cases of stroke. It has a variety of symptoms which are difficult to be correlated with radioimaging finding and leads to late diagnosis. This is due to its complexity in blood supply to many vital areas of the brain. Factors in radiological aspects like artefacts over posterior fossa in computed tomography of the brain contribute to the difficulties in its diagnosis. We present a case of late diagnosis of posterior circulation stroke due to challenges in correlating clinical and radiological findings. A 56-years-old woman with underlying hypertension experienced sudden onset of left eye ptosis associated with blurring of vision for a week as chief complaints when seeking medical attention. Her condition further deteriorated with reduced Glascow Coma Scale which warranted emergency intubation for airway protection.