BMJ Case Reports 2013; doi:10.1136/bcr-2013-008848

Internal carotid artery stenosis presenting as ipsilateral posterior cerebral artery ischaemic stroke: a lesson to be learnt

  1. Richard Geraghty1
  1. 1Department of Medicine, Redcliffe Hospital, Brisbane, Queensland, Australia
  2. 2School of Medicine, University of Queensland, Brisbane, Queensland, Australia
  3. 3Department of Radiology, Redcliffe Hospital, Brisbane, Queensland, Australia
  1. Correspondence to Dr Richard Geraghty, richard_geraghty{at}


A 71-year-old lady presented with a symptomatic left cerebral occipital lobe infarct. With a history of paroxysmal atrial fibrillation a cardioembolic source was initially postulated. Prior significant bleeding while anticoagulated precluded warfarin therapy. Further investigations revealed a critical left internal carotid stenosis with a persistent fetal origin of the left posterior cerebral artery. She was successfully treated surgically and suffered no further ischaemic events. Physicians encountering posterior circulation stroke should be aware of this potentially treatable important diagnosis.

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