Neurological Sciences

, Volume 40, Issue 10, pp 1995–2006 | Cite as

Posterior circulation ischaemic stroke—a review part I: anatomy, aetiology and clinical presentations

  • Marco SparacoEmail author
  • Ludovico Ciolli
  • Andrea Zini
Review Article


Posterior circulation ischaemia is a clinicopathological condition with complex symptomatology associated with an infarction within the vertebrobasilar arterial system. Posterior circulation strokes account for about 20–25% of all ischemic strokes and remain a significant cause of patient disability and mortality. Diagnosis can be challenging because presenting symptoms are often non-focal and because there is a substantial overlap in symptoms and signs of ischaemia in the anterior circulation. Despite better imaging techniques, diagnosis and treatment of life-threatening conditions, such as basilar artery occlusions, are often delayed. Therefore, early detection of symptoms and causes of posterior circulation ischaemia is essential for choosing the most appropriate therapy. In this review, we summarise the anatomy, aetiology, typical presentations and characteristic findings of common strokes resulting from disease in the vertebrobasilar arterial system.


Vertebrobasilar arterial system Posterior cerebral ischaemia Basilar artery occlusion 


Author contributions

Dr. Sparaco: study design, manuscript drafting/revising, study supervision.

Dr. Ciolli, Dr. Zini: manuscript drafting/revising.

Compliance with ethical standards

Conflict of interest

Marco Sparaco reports no disclosures.

Ludovico Ciolli reports no disclosures.

Andrea Zini reports received consultancy and speaker fees from Boehringer-Ingelheim, Medtronic, Stryker and Daiichi Sankyo.

We performed a review of the literature about the state of art of vertebrobasilar stroke; therefore, our work did not involve neither human participants nor experiments on animals.


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Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.Division of Neurology with Stroke Unit, Department of NeurosciencesA.O. “San Pio”, P.O. “G. Rummo”,Benevento (BN)Italy
  2. 2.Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile S. Agostino-EstenseModena University HospitalBaggiovaraItaly
  3. 3.UOC Neurologia e Rete Stroke metropolitana, Ospedale MaggioreIRCCS Istituto di Scienze Neurologiche di BolognaBolognaItaly

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