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Posterior cerebral artery stenosis.

M S Pessin, E S Kwan, L D DeWitt

Annals of Neurology

|January 1, 1987

Summary

Symptomatic posterior cerebral artery (PCA) stenosis often presents as transient ischemic attacks (TIAs), primarily visual or sensory. Atherostenosis in the PCA typically leads to more TIAs and fewer strokes compared to embolism.

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Area of Science:

Neurology
Vascular Neurology
Cerebrovascular Disease

Background:

Posterior cerebral artery (PCA) atherostenosis is a less common cause of cerebrovascular events compared to PCA embolism.
Understanding the distinct clinical presentation of PCA stenosis is crucial for accurate diagnosis and management.

Observation:

This study analyzed 6 patients with symptomatic PCA atherostenosis over a 7-year period.
Transient ischemic attacks (TIAs) were the predominant symptom, affecting 5 out of 6 patients.
Visual and sensory disturbances were the most common TIA symptoms, including unilateral visual field defects and paresthesias.

Findings:

Patients with PCA atherostenosis experienced a higher frequency of TIAs and a lower incidence of completed infarcts in the PCA territory compared to those with PCA embolism.
Homonymous visual field defects correlated with calcarine infarcts in two patients.
Warfarin treatment resulted in no new strokes in the PCA territory during follow-up, with only one patient experiencing recurrent TIAs.

Implications:

The clinical features of PCA stenosis, particularly the prevalence of visual and sensory TIAs, help differentiate it from other cerebrovascular conditions like middle cerebral artery stenosis.
Prompt recognition of PCA stenosis can guide appropriate anticoagulation therapy and potentially prevent future strokes.

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