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What Should I Do When Symptoms Are Suggestive Of Posterior Circulation Stroke?

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Posted on Thu, 13 Jan 2022
Question: Hello Doctor,

My mother is 49 year old and often exercises and has an healthy lifestyle. Over the past few months she has been suffering from persistent cough which lasted for almost 5 months and we consulted various doctors and undergone every suggested test and all the reports were normal. She was asked to use Rotocap inhaler capsules which helped overcome her cough and when she stopped using this, she started to feel weak and fatigue. Doctor asked to continue rotocaps for few more weeks as this could be the cause of her weakness. Along with Rotocap she used Ceftas CV for a week.

Now she doesn't have any cough, but from past two weeks she is suffering from strange symptoms with her eye sight - she has double vision when she sees things for more than few seconds and when she lies down, she feels dizzy and also sees the ground moving. But if she closes one eye, she is able to see things clearly (either eye) We consulted neurologist and he prescribed MRI along with B vitamin tablets and Vertin.

MRI showed no symptoms and everything appeared normal in the report. We again consulted the doctor and he asked to wait for a week and see if the symptoms increase.

But unable to see my mom's struggle, we even consulted acupuncture specialist and he gave a 10 page report which we are not able to follow. He asked us to go through the acupuncture treatment for 4 months everyday. We could not build the trust with them we are not willing to undergo acupuncture.

We are reaching out to specialist to provide some suggestions or treatment for this cause.

Awaiting your response.
doctor
Answered by Dr. Sudhir Kumar (40 minutes later)
Brief Answer:
Symptoms are suggestive of posterior circulation stroke.

Detailed Answer:

Hi,

These are suggestive of posterior circulation stroke, due to reduction of blood flow to brain. Normal MRI can be seen in minor cases of stroke. If symptoms do not start improving in a week's time, a repeat MRI brain with MR angiogram may be done.

As of now, she should be started on clopidogrel, a blood thinner. Vertin (betahistine) tablets can be given to relieve the symptoms of dizziness.

I sincerely hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.
     
Best wishes,     
Dr. Sudhir Kumar
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (16 minutes later)
Thank you doctor for your prompt reply.

It's been about 10 days that she took the MRI, and these symptoms are present now for about 2 weeks.

I have further questions:

- Can she stop using Rotacap capsule inhaler?
- Can she also use Immunace tablets?
- Does clopidogrel have any side effects and what is the dosage suggested? should this be taking in the morning or night?

Is this severe cause and something to worry or can be treated with medications alone?

Awaiting your response.
doctor
Answered by Dr. Sudhir Kumar (12 minutes later)
Brief Answer:
This is not a serious disease.

Detailed Answer:
Thank you for getting back.

Rotacap and immunace can be continued/stopped in consultation with pulmonologist/general physician.

Clopidogrel is generally safe. However, as it is a blood thinner, it may cause bleeding in small number of patients. The usual dose is 75 mg once daily after lunch.

It is not a serious disease and we expect improvement with medications.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (6 minutes later)
Thank you doctor.

We will use Clopidogrel and will keep you posted on her recovery.

If required we will consult you directly.

Once again thank you so much for your response. It's a great relief.
doctor
Answered by Dr. Sudhir Kumar (2 minutes later)
Brief Answer:
Sure, would be glad to see her.

Detailed Answer:
Please keep me informed about her progress.

I would be pleased to see her, if needed.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6231 Questions

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What Should I Do When Symptoms Are Suggestive Of Posterior Circulation Stroke?

Brief Answer: Symptoms are suggestive of posterior circulation stroke. Detailed Answer: Hi, These are suggestive of posterior circulation stroke, due to reduction of blood flow to brain. Normal MRI can be seen in minor cases of stroke. If symptoms do not start improving in a week's time, a repeat MRI brain with MR angiogram may be done. As of now, she should be started on clopidogrel, a blood thinner. Vertin (betahistine) tablets can be given to relieve the symptoms of dizziness. I sincerely hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr. Sudhir Kumar