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Posterior circulation stroke — RCPSC EM MCQ

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HardNeurological emergenciesPosterior circulation strokeRCPSC EM

A 62-year-old man presents with abrupt vertigo, vomiting and inability to walk. He has direction-changing nystagmus, skew deviation, and a normal early CT head. BP is 178/92 and he cannot sit unaided. What is the most likely diagnosis?

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Correct answer: B — Posterior circulation stroke

Severe acute vestibular syndrome with central HINTS features and truncal ataxia is posterior circulation stroke despite a normal early CT.

Reference: Canadian Stroke Best Practice Recommendations