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Posterior circulation stroke — RCPSC EM MCQ

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HardNeurological emergenciesPosterior circulation strokeRCPSC EM

CTAS 2: A 66-year-old has abrupt vertigo, vomiting and inability to walk. Vitals are BP 168/92, HR 84. Exam shows direction-changing nystagmus, skew deviation and limb ataxia. CT head is normal. Symptoms began 3 hours ago. What is the most likely diagnosis?

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Correct answer: D — Cerebellar stroke

Severe gait ataxia, central HINTS findings and vascular risk features suggest posterior circulation stroke despite normal early CT. Stroke pathway imaging is needed.

Reference: Canadian Stroke Best Practices; emergency vertigo evidence