Posterior cerebral artery (PCA) infarct
Posterior cerebral artery (PCA) infarcts arise, as the name says, from occlusion of the posterior cerebral artery. It is a type of posterior circulation infarction.
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Clinical presentation
Symptoms of posterior cerebral artery stroke include contralateral homonymous hemianopia (due to occipital infarction), hemisensory loss (due to thalamic infarction) and hemi-body pain (usually burning in nature and due to thalamic infarction) 3. If bilateral, often there is reduced visual-motor coordination 3. It is generally considered that sensory loss and hemianopia unilaterally without paralysis, is diagnostic of PCA territory stroke 4.
Because the PCA supplies the thalamus, PCA infarction can lead to contralateral thalamic syndrome.
Etiology
The most common causes of PCA strokes include atherosclerosis, small artery disease and embolism 5.
Treatment
Depending on the timing (within 4.5 hours), patients may be eligible for thrombolysis 4. If they preset after this window, patients may be suitable candidates for endovascular treatments (including stenting, angioplasty, mechanical embolectomy etc) 5.
The size of the vessel and unclear symptoms onset can make the treatment of acute ischemic stroke challenging 5.
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stroke and intracranial hemorrhage
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ischemic stroke
- general discussions
- scoring and classification systems
- signs
- by region
- hemispheric infarcts
- frontal lobe infarct
- parietal lobe infarct
- temporal lobe infarct
- occipital lobe infarct
- alexia without agraphia syndrome: PCA
- cortical blindness syndrome (Anton syndrome): top of basilar or bilateral PCA
- Balint syndrome: bilateral PCA
- lacunar infarct
-
thalamic infarct
- Déjerine-Roussy syndrome (thalamic pain syndrome): thalamoperforators of PCA
- top of the basilar syndrome
- striatocapsular infarct
- cerebellar infarct
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brainstem infarct
- midbrain infarct
- Benedikt syndrome: PCA
- Claude syndrome: PCA
- Nothnagel syndrome: PCA
- Weber syndrome: PCA
- pontine infarct
- Brissaud-Sicard syndrome
- facial colliculus syndrome
- Gasperini syndrome: basilar artery or AICA
- inferior medial pontine syndrome (Foville syndrome): basilar artery
- lateral pontine syndrome (Marie-Foix syndrome): basilar artery or AICA
- locked-in syndrome: basilar artery
- Millard-Gubler syndrome: basilar artery
- Raymond syndrome: basilar artery
- medullary infarct
- Babinski-Nageotte syndrome
- hemimedullary syndrome (Reinhold syndrome)
- lateral medullary stroke syndrome (Wallenberg syndrome)
- medial medullary syndrome (Déjerine syndrome)
- midbrain infarct
- acute spinal cord ischemia syndrome
- hemispheric infarcts
- by vascular territory
- treatment options
- complications
-
intracranial hemorrhage
-
intra-axial hemorrhage
- signs and formulas
- ABC/2 (volume estimation)
- CTA spot sign
- swirl sign
- by region or type
- signs and formulas
- extra-axial hemorrhage
-
intra-axial hemorrhage
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