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Transient Middle Cerebral Artery Occlusion Model of Stroke
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Published on: August 11, 2023

Posterior cerebral artery territory infarctions.

Carlo Cereda1, Emmanuel Carrera

  • 1Department of Neurology, Neurocenter (EOC) of Southern Switzerland, Ospedale Civico, Lugano, Switzerland.

Frontiers of Neurology and Neuroscience
|March 2, 2012
PubMed
Summary

Posterior cerebral artery (PCA) infarcts, though uncommon, cause diverse neurological deficits. Early thrombolysis is effective, but long-term cognitive and behavioral impairments following PCA strokes are often underestimated.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Stroke Medicine

Background:

  • Posterior cerebral artery (PCA) infarcts constitute 5-10% of ischemic strokes.
  • PCA anatomy includes deep (P1, P2) and superficial (P3, P4) segments, each supplying distinct brain regions.
  • PCA occlusions lead to varied clinical presentations depending on the affected territory.

Purpose of the Study:

  • To review the clinical manifestations and management of posterior cerebral artery (PCA) infarcts.
  • To highlight the spectrum of neurological deficits associated with PCA territory ischemia.
  • To emphasize the importance of recognizing and managing long-term consequences of PCA strokes.

Main Methods:

  • Literature review of studies on posterior cerebral artery (PCA) infarcts.
  • Analysis of clinical presentations based on anatomical location of PCA infarction.
  • Discussion of treatment modalities and outcomes for PCA stroke.

Main Results:

  • Deep PCA infarcts (P1, P2) can cause thalamomesencephalic syndromes (hypersomnolence, cognitive deficits, oculomotor paresis) or thalamic/choroidal artery territory lesions (hypesthesia, ataxia, sectoranopia).
  • Superficial PCA infarcts (P3, P4) frequently result in visual field defects, somatosensory deficits, reading disorders, or spatial neglect.
  • Bilateral PCA infarcts may lead to amnesia or cortical blindness; acute thrombolysis is beneficial, similar to anterior circulation strokes.

Conclusions:

  • Posterior cerebral artery (PCA) infarcts present with a wide range of focal neurological deficits.
  • While mortality is low, long-term cognitive and behavioral impairments following PCA strokes are significant and often overlooked.
  • Timely diagnosis and treatment, including thrombolysis, are crucial for improving outcomes in PCA stroke patients.