Posterior Circulation Stroke

Overview

A posterior circulation stroke occurs when the blood supply to the back of the brain is disrupted, affecting areas responsible for coordination, vision, and vital functions. This type of stroke can lead to life-altering physical, sensory, and cognitive impairments.

At The Royal Buckinghamshire Hospital, we specialise in inpatient neurorehabilitation for adults recovering from complex strokes, including posterior circulation stroke. Our multidisciplinary team supports recovery of balance, movement, vision, and independence.

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What Is a Posterior Circulation Stroke?

Posterior circulation strokes affect the vertebral and basilar arteries, which supply blood to the:

• Brainstem (controls breathing, heart rate, and alertness)
• Cerebellum (controls coordination and balance)
• Occipital lobes (responsible for vision)
• Thalamus and parts of the temporal lobe

These strokes account for around 20% of all ischaemic strokes and often present with more subtle or varied symptoms than anterior strokes.

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Causes of Posterior Circulation Stroke

The most common causes include:

• Blood clots or emboli
• Atherosclerosis (narrowing of arteries due to plaque)
• Vertebral artery dissection (often following neck trauma)
• Small-vessel disease
• Cardiac arrhythmias or other heart conditions

Stroke risk factors such as high blood pressure, diabetes, smoking, and atrial fibrillation apply to both anterior and posterior circulation strokes.

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Symptoms

Posterior strokes can be difficult to diagnose initially because symptoms may be subtle or fluctuate. Common signs include:

Physical and Sensory Symptoms

• Loss of coordination or unsteady walking (ataxia)
• Dizziness or vertigo
• Sudden loss of balance
• Double vision or blurred vision
• Nausea or vomiting
• Slurred speech (dysarthria)
• Trouble swallowing (dysphagia)
• Weakness or numbness (usually on one side)

Neurological Symptoms

• Sudden confusion or altered consciousness
• Visual field loss (homonymous hemianopia)
• Headache (especially in brainstem strokes)

Severe posterior strokes affecting the brainstem can result in coma or locked-in syndrome, though these are rare.

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Diagnosis

Diagnosis typically involves:

• MRI or CT brain scans
• CT angiography to visualise blood vessels
• Neurological examination
• Cardiac testing (e.g. ECG, echocardiogram)
• Blood tests to assess clotting and risk factors

Prompt diagnosis is essential, but recovery can continue for months with appropriate rehabilitation.

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Inpatient Stroke Rehabilitation at The Royal Buckinghamshire Hospital

Our consultant-led inpatient stroke programmes support recovery after complex strokes, including posterior circulation strokes. We deliver goal-focused rehabilitation through coordinated therapies.

Our rehabilitation includes:

Physiotherapy

• Balance and coordination training
• Gait retraining and walking aid assessment
• Vestibular rehabilitation (for dizziness)
• Muscle strengthening and mobility recovery

Occupational Therapy

• Upper limb rehabilitation
• Support with dressing, washing and everyday tasks
• Visual perception and spatial awareness training
• Cognitive rehabilitation (if affected)

Speech and Language Therapy

• Speech production and clarity improvement
• Support with swallowing
• Communication and cognitive-linguistic therapy

Neuropsychology

• Emotional support after stroke
• Memory, attention, and problem-solving strategies
• Adjustment therapy for life after stroke
• Support for anxiety, low mood or apathy

Specialist Nursing

• Medication support (e.g. anticoagulants)
• Continence and nutrition management
• Ongoing risk factor monitoring and education

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Who We Support

We support adults (18+) who:

• Are recovering from a posterior circulation stroke
• Have impairments affecting movement, balance, vision, or communication
• Require coordinated multidisciplinary inpatient care
• Are medically stable but need support to regain function and independence

Call 01296 678800 or enquire online to discuss our stroke rehabilitation programme.

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Why Choose The Royal Buckinghamshire Hospital?

• Specialist centre for stroke and neurological rehabilitation
• Consultant-led team with decades of experience
• Therapy available 7 days a week
• Quiet, private environment for focused recovery
• Tailored discharge planning and carer involvement