A Posterior Circulation Stroke Presenting with Isolated Truncal Ataxia

Area of Science:

• Neurology
• Vascular Neurology
• Neuroscience

Background:

• Vertebral artery dissection (VAD) is a rare cause of ischemic stroke, particularly in younger individuals.
• Posterior circulation strokes account for a significant portion of VAD-related events.
• VAD often presents with nonspecific symptoms, leading to diagnostic delays.

Observation:

• A case report details a patient experiencing a posterior circulation stroke secondary to VAD.
• The patient's primary presenting symptom was isolated truncal ataxia.
• Neurological examination revealed deficits primarily affecting balance and coordination.

Findings:

• The vertebral artery dissection was confirmed as the etiology of the posterior circulation stroke.
• Truncal ataxia was the sole initial neurological manifestation, mimicking other cerebellar or vestibular disorders.
• Diagnostic imaging confirmed the VAD and associated ischemic changes.

Implications:

• This case highlights the critical need for considering VAD in the differential diagnosis of stroke, even with atypical presentations like isolated truncal ataxia.
• A comprehensive neurological assessment, including careful evaluation of ambulation and balance, is crucial for early VAD detection.
• Timely diagnosis and management of VAD can prevent further ischemic events and improve patient outcomes.