To determine the average last-seen-well to treatment time for a series of patient that underwent intra-arterial treatment for posterior circulation strokes in a primary stroke center.

To determine the average time from ED physician evaluation to activation of the stroke team.

To identify the initial symptoms, risk factors and mortality at discharge in these patients.

Posterior circulation strokes due to large vessel occlusion, mainly basilar artery strokes represent a troublesome problem for neurologists and emergency physicians. They often lead to poor outcomes, and these outcomes are worse when revascularization therapy is delayed, underlying the importance of early symptoms recognition.

We performed a single-center, cross sectional study, collecting data of patients with posterior circulation strokes that underwent endovascular treatment from 2016 to 2018 in a Primary Stroke Center.

A total of 15 patients were included, the average age was 62 years. Eighty percent of patients had basilar artery occlusion. The average time from ED physician assessment to activation of the stroke team was 162 minutes. The average last-known-well to needle time was 476 minutes. Only 20% of these patients received IV tpa, the rest were excluded because they were out of the time window. Seventy-three percent had hypertension, 40% diabetes, 53% hyperlipidemia,  and 53% were smokers. The average NIHSS right before the endovascular treatment was 17.

The initial symptoms were dizziness in 53.3%, nausea and vomiting in 53%, dysarthria in 40%, hemiparesis in 40%, gait problems in 20%, headache in 20%, blurred vision in 7 % and lethargy in 7% of cases. Thirty-three percent died during their hospital stay.

Many of our patients presented with unspecific symptoms such as nausea and dizziness.

There was a delay in the activation of the stroke team after these patients arrived at the ED, this also led to delay in the treatment.