Posterior circulation cerebrovascular events comprise approximately 20% of ischemic events in the brain. Symptoms range from dizziness to profound ataxia altering gait. The majority of cases have some spectrum of dizziness. In this case report, we discuss a dorsolateral medullary stroke which atypically presented with dysphagia and without dizziness or ataxia. Although initial computed topography scans did not show large vessel occlusion or acute infarct, magnetic resonance imaging showed a right dorsolateral medullary infarct. Treatment is similar to other ischemic cerebrovascular accidents, including aspirin and high-intensity statin therapy, as well as thrombolysis if indicated. Pharyngeal dysfunction places a patient at higher risk for aspiration and pneumonia.
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