Posterior Circulation Stroke

Posterior circulation strokes are missed or misdiagnosed in up to a third of initial presentations — and a normal CT does NOT exclude them. This app is a fast, structured 8-step pathway for recognising and managing posterior circulation stroke at the bedside, built for clinicians by a stroke and neurology specialist.
Work through the whole pathway, or jump straight to the step you need:
• Step 1 — Overview & Red Flags: why posterior stroke is missed, the warning features, and immediate actions.

• Step 2 — HINTS Examination: an interactive Head Impulse, Nystagmus, Test of Skew tool that calls central vs peripheral at the bedside.

• Step 3 — Neuroimaging Protocol: CT limitations, the MRI sequences to request, and a CTA posterior protocol checklist.

• Step 4 — Posterior Circulation Syndromes: Wallenberg, cerebellar, basilar, top-of-basilar, lacunar and PCA — tap to expand.

• Step 5 — Basilar Artery Occlusion: BAO recognition, an interactive pc-ASPECTS calculator, the EVT pathway and ATTENTION/BAOCHE/BASICS criteria.

• Step 6 — Cerebellar Emergency: malignant oedema, suboccipital craniectomy and surgical escalation criteria.

• Step 7 — Aetiology & Secondary Prevention: vertebral artery dissection, atherosclerosis, cardioembolism, DAPT, DOAC and CADISS.

• Step 8 — MDT Handover & Rehabilitation: handover checklist, DVLA, SSNAP, vestibular rehab, dysphagia and thalamic pain.
Designed for fast reference on call: interactive HINTS and pc-ASPECTS tools, expandable syndrome cards, adjustable font size, and a full references section citing the underlying evidence (Kattah HINTS 2009, BASICS, ATTENTION, BAOCHE, CADISS, SAMMPRIS, POINT/CHANCE, NICE NG128 and RCP guidance).
Steps 1 and 2 are free to use. A single one-time purchase unlocks Steps 3–8 in full — no subscription.
For qualified healthcare professionals only. This app is for education and training and is not a substitute for clinical judgement, local protocols, or senior advice. Always follow your local stroke pathway and seek appropriate specialist input.