A case of bilateral PCA infarct presenting with marked behavioral symptoms and minimal neurological symptoms is presented here. [ijpm.info]

Apraxia of ocular movements is often present with bilateral lesions. Balints syndrome Some patients with bilateral occipital or parietooccipital infarctions present with Balints syndrome. [notes.medicosnotes.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]

Amnesia is usually said to require bilateral lesions but four cases in the present series appeared to have unilateral (left‐sided) occlusion. [onlinelibrary.wiley.com]

• Constipation

  Swedish Covenant Hospital, No. 12 L 3892 (Cook County) (2015) Medical Malpractice: 19 year old female presented to Swedish Covenant Hospital with complaints of constipation, abdominal pain and abdominal swelling. [prslaw.com]

• Hypertension

  Clinically, these vessels are the most common site of spontaneous hypertensive hemorrhage in individuals afflicted with long-standing hypertension. [medschool.slu.edu]

  Over-enthusiastic treatment of hypertension should be avoided. Treat hypertension, if hypertensive emergency exists, with one or more of these concomitant medical issues: Hypertensive encephalopathy. Hypertensive nephropathy. [patient.info]

  Modifying risk factors through lifestyle changes (eg, stopping cigarette smoking) and drug therapy (eg, for hypertension) can help delay or prevent subsequent strokes. [merckmanuals.com]

  The family at the bedside reported that the patient’s past medical history was significant for hypertension, diabetes mellitus type II, and hyperlipidemia. [karger.com]

  After the basal ganglia and internal capsule, the thalamus is the next most frequent site of hypertensive intracerebral hemorrhage and lacunar infarcts. [umassmed.edu]

• Heart Disease

  Other factors that make vascular disease more likely include Family history of vascular or heart diseases Pregnancy Illness or injury Long periods of sitting or standing still Any condition that affects the heart and blood vessels, such as diabetes or [icdlist.com]

  The physical examination should encompass a cardiologic and vascular examination, searching for arterial bruits, murmurs that suggest valvular heart disease, and signs of atrial fibrillation. [emedicine.medscape.com]

  Coronary and other heart disease. Diabetes mellitus. Drug misuse[3, 4]. Family history of stroke. Giant cell arteritis[5]. Obesity and physical inactivity[6]. Previous stroke. Race. Smoking[1, 7]. [patient.info]

  Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation. 2017 Mar 07;135(10):e146-e603. [PMC free article: PMC5408160] [PubMed: 28122885] 14. Wong KS, Caplan LR, Kim JS. Stroke Mechanisms. [ncbi.nlm.nih.gov]

• Hypotension

  However, in the presence of fetal type PCA, particularly when there is narrowing or occlusion in the ipsilateral ICA or when the cerebral perfusion is impaired (e.g., due to hypotension), watershed infarctions may occur in the territory supplied by PCA [hindawi.com]

  Treat hypotension: Intravenous fluids to maintain intravascular volume with isotonic fluids. Inotropes or vasopressors may be required. [patient.info]

  Nocturnal arterial hypotension and its role in optic nerve head and ocular ischemic disorders. Am. J. Ophthalmol. 1994, 117, 603–624. [Google Scholar] [CrossRef] Hayreh, S.S. [mdpi.com]

  Seizure with a postictal state Todd's Paresis Migraine Multiple Sclerosis Subarachnoid Hemorrhage Subdural Hematoma Vasculitis Hypoglycemia Hypotension Prognosis Stroke is a leading cause of disability and the fifth leading cause of death in the United [ncbi.nlm.nih.gov]

• 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]

  Right PCA Left homonymous hemianopsia due to damage to right visual cortex in the occipital lobe. [neuroanatomy.ca]

  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]

  […] neoplams, most often chromphobe adenoma with suprasellar extension or suprasellar neoplasm such as craniopharyngioma. ( b ) Hydrocephalus with ballooning of floor of third ventricle. 6, Optic tract or lateral geniculate loss (contralateral homonymous hemianopsia [dartmouth.edu]

  Infarctions in the territory of the PCA most often result in a contralateral hemianopsia. Other signs and symptoms depend on whether the infarction involves the thalamoperforator territory, and whether the infarction is left vs. right sided. [casemed.case.edu]

• Stroke

  This produces pure motor stroke or sensory-motor stroke contralateral to the lesion. [medicowesome.com]

  Acute stroke care in the US: results from 4 pilot prototypes of the Paul Coverdell National Acute Stroke Registry. Stroke. 2005 Jun. 36(6):1232-40. [Medline]. [Full Text]. Dirnagl U, Pulsinelli W. [medscape.com]

  Our case adds to the existing literature on a range of disguising presentations in PCA stroke. [ijpm.info]

  Stroke Thrombolysis Trialists’ Collaborative Group. [ahajournals.org]

  Further studies are needed to compare IAT and IVT for isolated PCA stroke. Copyright © 2011 S. Karger AG, Basel. [ncbi.nlm.nih.gov]

• Aphasia

  Signs and symptoms[edit] Peripheral Territory Lesions Contralateral homonymous hemianopsia[1][3] cortical blindness with bilateral involvement of the occipital lobe branches[4] visual agnosia[1] prosopagnosia[1] dyslexia, Anomic aphasia, color naming [en.wikipedia.org]

  In addition, left PCA lesions are sometimes associated with alexia without agraphia (patients can write, but cannot read what they have written); transcortical sensory aphasia (a receptive aphasia similar to Wernicke's aphasia except that repetition is [casemed.case.edu]

  Large infarctions in the left posterior temporal artery territory may produce an anomic or transcortical sensory aphasia Infarctions in the area of distribution of the penetrating branches of the PCA to the thalamus can result in aphasia If the left pulvinar [notes.medicosnotes.com]

  Extra notes: - A combination of sensory disturbance, motor weakness, and nonfluent aphasia suggests that an embolus has occluded the proximal superior division. - If a fluent (Wernicke’s) aphasia occurs without weakness, the inferior division of the MCA [medicowesome.com]

  Associated clinical signs were aphasia, alexia or a neglect syndrome, hemianopia, and hemisensory loss. Hemiplegia was due to infarction in the lateral midbrain. [ncbi.nlm.nih.gov]

• Dysarthria

  Dysarthria is common because of facial weakness. - When the dominant hemisphere is involved, global aphasia is present. - When the nondominant hemisphere is affected, anosognosia, constructional apraxia, and neglect are found. [medicowesome.com]

  Dysarthria and dysmetria of both upper extremities were noted, but overall the patient made a remarkable recovery from his condition the day before. [karger.com]

  Nineteen patients were presented with subarachnoid hemorrhage, 1 patient had neurologic deficits of hemiplegia and dysarthria, and 5 patients had incidental aneurysms with headache and dizziness. [koreamed.org]

  • Severe ipsilateral cerebellar ataxia • Nausea & vomitings • Dysarthria • Contralateral loss of pain & temperature over extremities, body & face. • Partial deafness, ataxic tremor of ipsilateral UL, Horner’s syndrome & Palatal myoclonus rare Superior [slideshare.net]

• Confusion

  […] read what they have written); transcortical sensory aphasia (a receptive aphasia similar to Wernicke's aphasia except that repetition is relatively spared); and Gerstmann's syndrome (a combination of acalculia, finger agnosia, agraphia, and right/left confusion [casemed.case.edu]

  The sequelae of PCA infarct include acute vision loss, confusion, new onset posterior cranium headache, paresthesias, limb weakness, dizziness, nausea, memory loss and language dysfunction. [neuroradiologyonthenet.blogspot.com]

  Stroke complications can include sleep problems, confusion, depression, incontinence, atelectasis, pneumonia, and swallowing dysfunction, which can lead to aspiration, dehydration, or undernutrition. [merckmanuals.com]

  Lacunes may be confused with other empty spaces, such as enlarged perivascular Virchow-Robin spaces (VRS). The VRS are extensions of the subarachnoid space that accompany vessels entering the brain parenchyma. [radiologyassistant.nl]

  If these structures are involved, the patient may present with confusion, or memory impairment (thalamic or medial temporal amnesia). [aibolita.com]

• Neglect

  Associated clinical signs were aphasia, alexia or a neglect syndrome, hemianopia, and hemisensory loss. Hemiplegia was due to infarction in the lateral midbrain. [ncbi.nlm.nih.gov]

  Some patient with Proximal PCA occlusion may simulate MCA occlusion when it result in Hemiparesis Hemianopsia Hemispatial neglect Aphasia Sensory inattention. Cortical signs are probably explained by thalamic involvement [notes.medicosnotes.com]

  With right sided PCA lesions, patients may have a visual neglect. They may also have prosopagnosia, an inability to recognize familiar faces. [casemed.case.edu]

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]

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]

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]

(March 2018) Treatment[edit] This section is empty. You can help by adding to it. [en.wikipedia.org]

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]

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]

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]

Keywords: Stent-assisted coil embolization; Hemorrhagic P1 dissection; Posterior cerebral artery Introduction Hemorrhagic dissecting aneurysms of cerebral artery tend to rebleed and the prognosis after rebleeding is poor. [austinpublishinggroup.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.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]

We presented a patient with a posterior cerebral artery territory infarction due to an unexpected etiology as stenosis of internal carotid artery (ICA) with existence of fetal type PCA. 1. [hindawi.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]

In spite of thorough diagnostic evaluation, the etiology of PCA territory infarction cannot be determined in at least one quarter of patients. [ncbi.nlm.nih.gov]

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]

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]

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]

(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]

Posterior Cerebral Artery The posterior cerebral arteries stem in most individuals from the basilar artery but sometimes originate from the ipsilateral internal carotid artery [Garcia JH et al., In Barnett HJM at al (eds) Stroke Pathophysiology, Diagnosis [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]

[…] to Prevent and Treat Stroke Complications ); these measures clearly improve clinical outcomes ( 1 ). [merckmanuals.com]

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]

This experience, although limited, suggests that to prevent unexpected complications as in this case, it needs more attentive involvement of neurologists as a consultant.Korean Journal of Stroke 1999;1(1):91~94 [dbpia.co.kr]

See also the separate Stroke Prevention article. [patient.info]