Dysphagia as dominant symptom of posterior circulation stroke: a case report illustrating the diagnostic difficulty

Abstract

Posterior ischemic strokes are relatively rare and difficult to diagnose. Its main differential diagnosis is made with cerebral neoplasia. In the present article, we report an atypical case of a 70-year-old man, who presented with dysphagia as a dominant symptom with right facial palsy and right hemiparesis, associated with a chronic biological inflammatory syndrome. A brain cancer cause would be the most expected diagnosis. Brain MRI revealed multiple foci of bilateral posterior ischemic stroke suggestive of an embolic cause. Medical investigations allowed excluding cardioembolic disease, infectious, malignancies and other rheumatic affections. The only cause highlighted was a significant bilateral atheromatous spinal stenosis.  

Received: March 7^th, 2024

Accepted: July 25^h, 2024

https://dx.doi.org/10.4314/aamed.v17i4.15