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[Difficulty in reaching objects due to posterior cerebral artery occlusion]

N Takahashi1, M Kawamura

  • 1Department of Neurology, Kimitsu Chuo Hospital, Chiba, Japan.

Rinsho Shinkeigaku = Clinical Neurology
|November 7, 1998
PubMed
Summary

Two patients experienced impaired hand reaching after left posterior cerebral artery occlusion. This suggests kinesthesia impairment, potentially involving the parietal lobe via the lateral pulvinar.

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Area of Science:

  • Neuroscience
  • Neuro-ophthalmology

Background:

  • Posterior cerebral artery (PCA) occlusions can lead to diverse neurological deficits.
  • Reaching movements rely on complex sensorimotor integration, involving visual and proprioceptive feedback.

Observation:

  • Two patients presented with impaired right-hand reaching movements following left PCA occlusion.
  • Deficits were noted in reaching own body parts with eyes closed and reaching external objects with eyes open.
  • No significant motor paralysis, ataxia, or sensory disturbances were observed, except for mild proprioception issues in one patient.

Findings:

  • Impaired kinesthesia (sense of limb position and movement) was identified as the primary cause of reaching difficulties.
  • CT scans revealed lesions in the left temporal, occipital lobes, and lateral pulvinar.

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  • These lesions correlate with impaired kinesthesia and ataxie optique, suggesting a pathway involving the lateral pulvinar to the parietal association cortex.

    • Implications:

    • The study highlights the role of the lateral pulvinar in kinesthetic processing and sensorimotor control.
    • Findings suggest a neural pathway for kinesthesia projecting through the lateral pulvinar to the parietal lobe.
    • Understanding these pathways is crucial for diagnosing and treating reaching impairments after PCA stroke.