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Acute ischemic stroke, a medical emergency caused by reduced cerebral blood flow, results in brain cell damage. While commonly associated with older individuals, strokes can also occur in young and middle-aged adults, posing significant socio-economic and health challenges due to the long-term impact of the condition. This poses significant socio-economic and health challenges because stroke is a leading cause of disability and mortality.

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Bilateral vertebral artery dissections account for only 8% of all vertebral artery dissections and cause just 2% of all ischemic strokes. They can occur spontaneously, even without any triggering factor. Classical clinical findings, such as headache or neck pain, may be absent, particularly in the context of a stroke.

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Limb disorders and slurred speech are common clinical symptoms associated with acute ischemic stroke. Although urinary incontinence is a known symptom in many cases of acute ischemic stroke, the simultaneous impairment of both bowel and bladder function is relatively rare. The occurrence of fecal and urinary incontinence as the primary clinical manifestation in minor acute ischemic stroke is especially uncommon.

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Hypereosinophilic syndrome (HES) is traditionally described as chronic peripheral eosinophilia with involvement of various organs and systems, including the heart and nervous system. In this report, we describe cardiac involvement and border zone stroke in a patient with idiopathic HES. A 37-year-old woman presented with sudden right-sided weakness and slurred speech, which began four days before admission, accompanied by palpitations, retrosternal exertional chest discomfort, dry cough, and progressive shortness of breath over approximately two months.

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This case report discusses a unique presentation of an artery of Percheron (AOP) infarct resulting in rapidly resolving internuclear ophthalmoplegia (INO) without classical signs. This is the case of a 70-year-old male patient who presented to a community Emergency Department following acute code stroke activation. Physical exam and imaging studies including non-contrast CT, CT angiography, CT perfusion, and MRI were performed.

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