Diagnosing posterior circulation strokes

Diagnosing posterior circulation strokes presents significant challenges, necessitating a keen awareness of key criteria to prevent misdiagnosis. Apostolos Safouris, MD, PhD, Athens Metropolitan Hospital, Athens, Greece, emphasizes the need for comprehensive clinical and imaging evaluation to maximize the chances of catching these strokes early. The subtlety and non-focal nature of signs often complicate the diagnostic process and they remain more difficult to recognize and treat effectively than other stroke types. Notably, in cases of basilar artery occlusion (BAO), there can be a delay of hours before full-blown symptoms, like hemiplegia or coma, manifest. Neuroimaging is of paramount importance in this context, with computed tomography angiography (CTA) known to enhance the use of endovascular treatment. Even patients with mild symptoms that could be suggestive of BAO should undergo CTA promptly to ensure timely intervention. The diagnosis of posterior circulation strokes demands specialist assessment and timely imaging investigation as patient outcomes can be vastly different when diagnosed early. This interview took place during the European Stroke Organisation Conference (ESOC) in Munich, Germany.

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