Dual territory (embolic) stroke

Case contributed by Dr Ian Bickle


An elderly female is initially admitted with a visual deficient. During her hospital stay she develops balance problems.

Patient Data

Age: 75
Gender: Female

CT performed on admission.

Territorial area of low attenuation with sulcal effacement in the left occipital lobe.  No internal haemorrhage.


Five days into admission, new symptoms developed and the CT was repeated.

The previously identified left occipital lobe infarction is now more pronounced, due to maturation.

A new territorial area of low attenuation have developed in the inferomedial left cerebellar hemisphere.  No internal haemorrhage.

Case Discussion

This case demonstrates a dual territory infarction, within less than a week.   A posterior cerebral artery (PCA) territory infarct in the supratentorial brain, followed by a posterior inferior cerebellar artery (PICA) territory infarct in the infratentorial brain.

These cerebral infarcts (ischaemic stroke) were embolic in nature.

Watch a fantastic series of educational videos collated by our founder Dr Frank Gaillard on the youtube radiology channel: stroke series

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Case information

rID: 25377
Case created: 22nd Oct 2013
Last edited: 1st Dec 2016
Tags: stroke, pica
Inclusion in quiz mode: Included

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