Understanding Posterior Circulation Syndrome

Posterior Circulation Syndrome, or a Posterior Circulation Stroke is the disruption of blood flow to the regions of the brain located on the front end. Also known as Posterior Circulation Infraction, this condition surfaces when the sensitive brain cells and tissues in this region are deprived of essential oxygen, making them unable to perform their function.

Ischemic strokes that result from posterior circulation syndrome represent about 20% of all stroke cases. Hence, this type of brain injury is less prevalent compared to anterior circulation syndrome.

Symptoms of Posterior Circulation Stroke

The onset of signs and symptoms for posterior circulation syndrome is different for every patient. Depending on the extent of damage caused and the severity of the occlusion in the brain, posterior circulation TIA symptoms can be a mix of the following:

Dizziness: The most common symptom of posterior circulation stroke is dizziness. With the brain under pressure because of the damaged neurons, the person experiences loss of balance and gets dizzy easily. Since neurological coordination suffers in a posterior circulation infract, the brain is unable to communicate with the muscles of the body in a timely manner.

Neck Pain and Headaches: Suffering from sudden but persistent pain in the neck, shoulders and head makes posterior circulation TIA a very uncomfortable state. When the onset of a stroke becomes imminent, the intensity of these aches increases.

Loss of Sensation: When the damage to the posterior regions of the brain is intense, there is chance that the patient may lose sensation in different parts of the body. This usually happens on either the right or the left side and affects the limbs and lower torso. Numbness in the fingers and the drooping of the mouth are also part of this symptom.

Diplopia: Commonly referred to as Double Vision, diplopia is a condition that gives an individual a perception of seeing two images of a single object. Such a condition comes about as a result of the damage caused to the vision centre in the aftermath of posterior circulation syndrome. Precisely, it is owing to the irregular function of the Extraocular Muscles, because while both eyes are working normally, they are unable to converge the right and left views of a single image.

The loss of overall balance of the body can also be attributed to this symptom of posterior circulation stroke. Diplopia can either be horizontally, vertically or diagonally inclined; or a mix of all in very extreme cases.

Dysphagia: Dysphasia is a condition associated with the swallowing muscles in the throat. If a patient suffers from muscle weakness or worse, paralysis, the tendons in the throat refuse to contract and relax to ingest food particles. As a result, a posterior circulation TIA patient is unable to take any food or drink orally, at least immediately after the stroke. Feeling food getting stuck behind the throat, experiencing pain while swallowing, coughing, drooling and gagging are all part of dysphagia.

Vertigo: Another visual symptom of posterior circulation syndrome, vertigo is a feeling that the person or the objects around him are constantly in motion, when they are actually not. It is similar to feeling dizzy and worsens if the individual moves his head in any direction. 7%-10% of patient’s suffering brain damage as a result of posterior circulation syndrome are known to experience vertigo.

Altered Consciousness Levels: Alertness and consciousness may seriously be affected during posterior circulation syndrome. A person may hardly be conscious to talk and interact with caregivers because the brain in unable to produce enough energy to keep bodily activities up and going.

Homonymous Hemianopsia: Hemianopsia is the loss of the vision field of the right or left side. Homonymous hemianopsia is the loss of the same field side in both eyes. The right side of the brain has visual pathways for the left field of both eyes, while the left half of the brain has the visual pathways for the right filed of both eyes. If the neurons network in either of these parts suffers as a result of a stroke, one half of the visual field is lost. This symptom of posterior circulation infraction leaves a person virtually blind because it robs him of the capability of adding meaning and life into the images he sees.

Dysarthria: In layman terms, Dysarthria is the improper delivery of speech that a listener cannot understand. This condition surfaces because of damage to the muscles that help produce speech and pronounce words- hence, it is the damage to motor control in the motor-speech centre. Therefore, dysarthria is not a cognitive problem because the individual can think and process words, he is just unable to communicate them.

Nystagmus: Involuntary eye movements that make the pupil ‘dance’. Nystagmus is a condition that makes it impossible for a posterior circulation syndrome patient to focus on a single object and make sense of it.

Posterior Circulation Stroke Treatment

Posterior Circulation Stroke Treatment options focus on improving the affects of the neurological damage caused to the brain. While most of the conditions discussed above cannot be treated completely, they can be improved upon so that when the patient gets back to routine life he can manage to live with the disabilities.

The most direct Posterior Circulation Stroke Treatment is in the form of Mechanical Thrombectomy, a surgical procedure in which a neurosurgeon sends a stent retriever to the site of the blockade and tries to pull it out to restore the flow of blood.

Once the blockade in the posterior arteries is extracted, the patient has a long recovery road ahead of him. Physiotherapy is a proven regime that helps induce flexibility back into the muscles of the limbs so that a posterior circulation syndrome patient can start walking again. A physiotherapist aids patients while they perform exercise and monitors their progress in each sitting.

Similarly, occupational therapy is another posterior circulation stroke treatment that focuses on giving patients some independence as they recover from the side effects of posterior circulation syndrome. Occupational therapists teach adaptability and the use of alternative ways and means to complete everyday tasks. Since the disabilities after a stroke are crippling, the use of crutches, hearing aids and visual aids can help restore some level of confidence and self esteem.