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.

Modality: CT

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.

Modality: CT

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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