Presentation
Visual hallucinations were the presenting symptoms in 2 patients with probable infarcts in the territory of a posterior cerebral artery. They occurred in areas of paracentral scotomas, right in Patient 1 and left in Patient 2. [ncbi.nlm.nih.gov]
The most common presenting symptom of PCA dissection is occipital headache. [ruralneuropractice.com]
This case presents a departure from the presentation of a traditional posterior circulation cerebral infarction most likely as a result of a rare vascular anomaly rooted in an aberrant embryological process. [karger.com]
Entire Body System
-
Hunting
Neurosurgery 2000;47:359–366 Hunt WE, Kosnick ES. Timing around perioperative care in intracranial aneurysms surgery. Clin Neurosurg 1974;21:79–89 Padget DH. The development of the cranial arteries in the human embryo. [ajnr.org]
Each patient was evaluated according to the Hunt and Hess (HH) grading scale on admission, which ranged from Grade 1 to 5. [thejns.org]
-
Burning Pain
Often there is giperpatiya, and after a few weeks or months in the affected areas may develop a painful burning pain. Patients describe it as a compressed, contracting, chilling, cutting. [minclinic.ru]
pain – Persistent, poor response to analgesics – Anticonvulsants (Carbamazepine, gabapentin) & TCAs used. [slideshare.net]
-
Pseudotumor
[…] abscess (Medical Encyclopedia) Brain surgery (Medical Encyclopedia) Central pontine myelinolysis (Medical Encyclopedia) Cerebral spinal fluid (CSF) collection (Medical Encyclopedia) EEG (Medical Encyclopedia) Hepatic encephalopathy (Medical Encyclopedia) Pseudotumor [icdlist.com]
Cardiovascular
-
Venous Insufficiency
Aortic arch syndrome (Medical Encyclopedia) Arterial embolism (Medical Encyclopedia) Arteriogram (Medical Encyclopedia) Cerebral angiography (Medical Encyclopedia) Duplex ultrasound (Medical Encyclopedia) Venous insufficiency (Medical Encyclopedia) Venous [icdlist.com]
Eyes
-
Hemianopsia
Abstract The authors report a case of isolated homonymous hemianopsia secondary to embolic occlusion of the posterior cerebral artery. The cause of embolism was demonstrated to be spondylitic vertebral artery compression. [ncbi.nlm.nih.gov]
/thalamus & rt occipital lobe (major) 4 10 77, F SAH Rt P2 Medium/saccular Yes PAO/6 coils Paralysis & hemianopsia/thalamus & rt occipital lobe (major) 3 11 49, F SAH Lt P2 Medium/fusiform Yes PAO/5 coils Paralysis & hemianopsia/thalamus & rt occipital [thejns.org]
Right PCA Left homonymous hemianopsia due to damage to right visual cortex in the occipital lobe. [neuroanatomy.ca]
Whereas a pituitary tumor compressing the optic chiasm results in bilateral temporal heteronymous hemianopsia (where heteronymous means in two different visual fields). [forums.studentdoctor.net]
Conclusion: Korean medicine treatment can be considered an effective treatment for homonymous hemianopsia in stroke patients. Keywords case report;homonymous hemianopsia;Bojungikki-tang;visual field test;visual defect [koreascience.or.kr]
-
Vertical Gaze Palsy
Vertical gaze palsy and horizontal gaze weakness are both clinical signs exhibited by this patient that indicate that he experienced rostral brainstem infarction [1, 5]. [karger.com]
Coma with vertical gaze palsy: relevance of angio-CT in acute Percheron artery syndrome. Case Rep Neurol, 2 (2010), pp. 74-79 [7] L. Rivera-Lara, N. Henninger. Delayed sudden coma due to artery of Percheron infarction. [elsevier.es]
Midbrain syndromes: Vertical gaze palsy. Third cranial nerve palsy. Pontine syndromes: Tremor, ataxia and mild hemiparesis. Horizontal gaze palsy. Cranial nerve VI and VII palsies. [patient.info]
Psychiatrical
-
Euphoria
Such a damage is often accompanied by abulia and a state of euphoria conducive to the emergence of abulia. CT and MRI can detect bilateral lesions, resembling in its outline of a butterfly, and in subtalamuse srednenizhnih parts of the thalamus. [minclinic.ru]
Neurologic
-
Gerstmann Syndrome
syndrome (a combination of acalculia, finger agnosia, agraphia, and right/left confusion). [casemed.case.edu]
syndrome Astereognosis occipital lobe: Bálint's syndrome Cortical blindness Pure alexia temporal lobe: Cortical deafness Prosopagnosia Thalamus Thalamic syndrome Other Subclavian steal syndrome Upper motor neurone lesion (Clasp-knife response) Lower [en.wikipedia.org]
syndrome and hand motor deficit (one case). [ajnr.org]
-
Dysmetria
The neurological exam revealed cerebellar signs, including dysmetria of the right upper extremity and a decreased level of consciousness. [karger.com]
[…] ophthalmoplegia One and a half syndrome Midbrain (CN 3, 4) Weber's syndrome ventral peduncle, PCA Benedikt syndrome ventral tegmentum, PCA Parinaud's syndrome dorsal, tumor Nothnagel's syndrome Claude's syndrome Other Alternating hemiplegia Cerebellum lateral (Dysmetria [en.wikipedia.org]
• D/D: Viral labrynthitis (Headache, neck stiffness & unilateral dysmetria favor stroke) CEREBELLAR INFARCTION 48. THANK YOU Dr.Karthik Raghavan Postgraduate MD (Int. Med) SRM Medical College & Hospital [slideshare.net]
-
Temporary Amnesia
From present evidence it is concluded that lesions confined to the left side may cause temporary amnesia, but that the evidence for permanent amnesia is inconclusive. [onlinelibrary.wiley.com]
In addition, diffusion-weighted Imaging in patients with transient global amnesia has demonstrated lesions in unilateral temporal lobes resulting in temporary amnesia. [emedicine.medscape.com]
-
Cerebellar Sign
Medial pontine syndrome – occlusion of paramedian branch of basilar artery A.IPSILATERAL 1.Gaze paresis 2.Cerebellar signs B.CONTRALATERAL 1.Hemiparesis 2.Hemianaesthesia 35. [slideshare.net]
The neurological exam revealed cerebellar signs, including dysmetria of the right upper extremity and a decreased level of consciousness. [karger.com]
Workup
Conclusion The symptomatology of the patient did not align with all of the deficits that usually present with an infarction of the posterior circulation, and the radiological workup revealed an fPCA on the right side. [karger.com]
Additional tests can be ordered such as ANA with titers, ESR, CRP, ANCA for vasculitis, hypercoagulable panel for coagulopathy, and genetics tests for an unknown cause of stroke after the first workup. [ncbi.nlm.nih.gov]
Angiography
-
Mural Thrombus
A second scan performed 96 hours after the head injury revealed a mural thrombus at the tip of the basilar artery without any evidence of infarction. A third scan performed 12 days later revealed that the thrombus had resolved. [ncbi.nlm.nih.gov]
Treatment
Endovascular treatment techniques provide additional treatment options. In selected cases, high revascularization rates following microsurgical thromboembolectomy in the anterior circulation were reported. [ncbi.nlm.nih.gov]
Endovascular treatment techniques provide additional treatment options. In selected cases, high revascularization rates following microsurgical thrombembolectomy in the anterior circulation were reported. [neurosurgerycns.wordpress.com]
The benefit of mechanical thrombectomy (MT) compared to IV thrombolysis (tPA) for the treatment of an acute posterior cerebral artery (PCA) occlusion is uncertain. [journals.heart.org]
No neurologic deficit occurred after treatment. Clinical presentations and grades were typical. [ajnr.org]
Prognosis
Recognition of this syndrome has implications for management and prognosis. [ncbi.nlm.nih.gov]
Keywords : Stroke; Carotid artery internal; Posterior cerebral artery; Anterior choroidal artery; Anatomy; Prognosis. [scielo.org.co]
Conclusion : Carotid artery invasion by malignancy portends a poor prognosis. Carotid artery resection can provide reasonable palliation. The head and neck surgeon faces a d i fficult dilemma because of its high mortality and neurologic morbidity. [dbpia.co.kr]
In our series, the preoperative clinical grade was the only factor that influenced the prognosis. In all patients, the clinical grade was good or very good. [ajnr.org]
Links: anatomy risk factors pathogenesis clinical features investigations management prognosis General Practice Notebook General Practice Notebook The information provided herein should not be used for diagnosis or treatment of any medical condition. [gpnotebook.co.uk]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
The clinical evidence for herniation itself includes an ipsilateral dilated pupil and contralateral hemiparesis, though these may be difficult to discern in the setting of already increased intracranial pressure due to the underlying etiology. [neuroradiologyonthenet.blogspot.com]
Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. [books.google.com]
Etiologies: Most often embolic from heart, aorta or the internal carotid artery. Rarely, due to intrinsic atherosclerotic disease of the ACA. [casemed.case.edu]
In this case, due to the configuration and distal location of the aneurysm in the posterior circulation, it was probable that dissection was the etiology. [ruralneuropractice.com]
Epidemiology
However, there are no epidemiological P2 segment and distal aneurysm data so far. The literature regarding the therapy of P2 segment and distal aneurysms are extremely limited to small case series and case reports. [thejns.org]
Epidemiology A relatively uncommon form of stroke. However: Stroke is the fourth[2]biggest cause of death in the UK. 25% of lesions causing stroke occur in the vertebrobasilar circulation[1]. [patient.info]
General epidemiological characteristics and clinical presentation are reported in Table 1. Table 1. Characteristics of stroke and stroke mimic population. [scielo.br]
Vertebrobasilar Dolichoectasia (VBD) is another occasional cause of PCA stroke. [11] Epidemiology Stroke, a leading cause of adult disability, [12] is the fifth leading cause of death in the United States. [ncbi.nlm.nih.gov]
Pathophysiology
(eds) Mohr JP, Choi DW, Grotta JC, et al: Stroke: Pathophysiology, Diagnosis and Managemen 4 Philadelphia, Churchill Livingstone, 2004;167-192 Caplan LR, Bogousslavsky J: Posterior cerebral artery syndromes. [karger.com]
[…] of moyamoya disease: an update J Stroke 2016 18 12 20 4 Najm IM Tilelli CQ Oghlakian R Pathophysiological mechanisms of focal cortical dysplasia: a critical review of human tissue studies and animal models Epilepsia 2007 48 Suppl 2 21 32 5 Abe T Singer [j-nn.org]
In Barnett HJM at al (eds) Stroke Pathophysiology, Diagnosis, and Management New York Churchill Livingstone 1992 125]. The posterior arteries supply the temporal and occipital lobes of the left cerebral hemisphere and the right hemisphere. [strokecenter.org]
Palinopsia, micropsia, and macropsia These are illusory phenomena that are of uncertain pathophysiology. Palinopsia describes the persistence of a visual image for several seconds to days in a partially blind hemifield. [emedicine.medscape.com]
Prevention
[…] to Prevent and Treat Stroke Complications ); these measures clearly improve clinical outcomes ( 1 ). [merckmanuals.com]
In order to prevent repeated embolism of the arterial lumen prescribe anticoagulants (heparin ). When atherosclerotic occlusion of the posterior cerebral artery of a specific treatment is needed. [minclinic.ru]
See also the separate Stroke Prevention article. [patient.info]
Blood thinners such as aspirin or clopidogrel can help prevent a clot from forming in the artery. Statins can help prevent the continued build up of cholesterol plaque in the artery. [cedars-sinai.edu]
Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. [books.google.es]