Posterior Cerebral Artery Infarct with Haemorrhagic Transformation

A 65-year-old female presented with visual disturbances a week following surgical breast biopsy and stopping eliquis. A diagnosis of a perioperative posterior cerebral ischemic stroke with haemorrhagic transformation, in the setting of eliquis cessation, was made. Despite several features in this case suggesting a posterior cerebral artery cardio embolic ischemic stroke, differentials such as infarctions of the anterior circulation and middle cerebral artery, other possible causes of posterior circulation stroke, acute peripheral vestibular dysfunction, intracranial or subarachnoid haemorrhage, neoplasms, basilar migraine, toxic or metabolic disturbances, neuro- nflammatory or chronic infectious conditions, and ocular vascular disorders should be considered. Prompt detection and diagnosis of cardio embolic cerebral infarction is crucial to initiate long-term anti-coagulant therapy for secondary prevention. Clinicians should maintain a high index of suspicion for the signs and symptoms of stroke. Apart from a detailed history, a complete neurological examination with appropriate imaging will aid clinicians in detection, diagnosis and prevention of stroke with appropriate referral and management.