Which circulation is most likely involved when a patient presents with ataxia, vertigo, and nausea?

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Multiple Choice

Which circulation is most likely involved when a patient presents with ataxia, vertigo, and nausea?

Vertebrobasilar (posterior) circulation supplies the brainstem and cerebellum, where the vestibular nuclei and cerebellar circuits reside. When this circulation is affected, you commonly see vertigo, nausea, and ataxia due to disruption of balance and vestibulo-oculomotor pathways. In contrast, anterior circulation feeds cortical areas involved in language, executive function, and motor planning; occlusions here usually cause aphasia, neglect, or weakness rather than prominent vertigo and gait ataxia. While the vestibular cortex and dorsal-medial thalamus participate in balance and sensory integration, they are not the primary regions supplied by the anterior circulation—so the pattern of symptoms aligns best with posterior circulation involvement.

Vertebrobasilar (posterior) circulation supplies the brainstem and cerebellum, where the vestibular nuclei and cerebellar circuits reside. When this circulation is affected, you commonly see vertigo, nausea, and ataxia due to disruption of balance and vestibulo-oculomotor pathways. In contrast, anterior circulation feeds cortical areas involved in language, executive function, and motor planning; occlusions here usually cause aphasia, neglect, or weakness rather than prominent vertigo and gait ataxia. While the vestibular cortex and dorsal-medial thalamus participate in balance and sensory integration, they are not the primary regions supplied by the anterior circulation—so the pattern of symptoms aligns best with posterior circulation involvement.

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