Posterior cerebral artery syndrome is a condition whereby the blood supply from the

posterior cerebral artery The posterior cerebral artery (PCA) is one of a pair of cerebral arteries that supply oxygenated blood to the occipital lobe, as well as the medial and inferior aspects of the temporal lobe of the human brain. The two arteries originate from the d ...

(PCA) is restricted, leading to a reduction of the function of the portions of the

brain The brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head (cephalization), usually near organs for ...

supplied by that vessel: the

occipital lobe The occipital lobe is one of the four Lobes of the brain, major lobes of the cerebral cortex in the brain of mammals. The name derives from its position at the back of the head, from the Latin , 'behind', and , 'head'. The occipital lobe is the ...

, the inferomedial

temporal lobe The temporal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The temporal lobe is located beneath the lateral fissure on both cerebral hemispheres of the mammalian brain. The temporal lobe is involved in pr ...

, a large portion of the

thalamus The thalamus (: thalami; from Greek language, Greek Wikt:θάλαμος, θάλαμος, "chamber") is a large mass of gray matter on the lateral wall of the third ventricle forming the wikt:dorsal, dorsal part of the diencephalon (a division of ...

, and the upper

brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is conti ...

and

midbrain The midbrain or mesencephalon is the uppermost portion of the brainstem connecting the diencephalon and cerebrum with the pons. It consists of the cerebral peduncles, tegmentum, and tectum. It is functionally associated with vision, hearing, mo ...

. This event restricts the flow of blood to the brain in a near-immediate fashion. The blood hammer is analogous to the

water hammer Hydraulic shock ( colloquial: water hammer; fluid hammer) is a pressure surge or wave caused when a fluid in motion is forced to stop or change direction suddenly: a momentum change. It is usually observed in a liquid but gases can also be aff ...

hydrology Hydrology () is the scientific study of the movement, distribution, and management of water on Earth and other planets, including the water cycle, water resources, and drainage basin sustainability. A practitioner of hydrology is called a hydro ...

, and consists of a sudden increase of the upstream blood pressure in a blood vessel when the bloodstream is abruptly blocked by vessel obstruction. Complete understanding of the relationship between mechanical parameters in vascular occlusions is a critical issue, which can play an important role in the future diagnosis, understanding and treatment of vascular diseases. Depending upon the location and severity of the occlusion, signs and symptoms may vary within the population affected with PCA syndrome. Blockages of the proximal portion of the vessel produce only minor deficits due to the collateral blood flow from the opposite hemisphere via the posterior communicating artery. In contrast, distal occlusions result in more serious complications. Visual deficits, such as

agnosia Agnosia is a neurological disorder characterized by an inability to process sensory information. Often there is a loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is neither defective nor i ...

, prosopagnosia or cortical blindness (with bilateral infarcts) may be a product of ischemic damage to

. Occlusions of the branches of the PCA that supply the thalamus can result in central post-stroke pain and lesions to the subthalamic branches can produce “a wide variety of deficits”. Left posterior cerebral artery syndrome presents alexia without

agraphia Agraphia is an acquired neurological disorder causing a loss in the ability to communicate through writing, either due to some form of motor dysfunction or an inability to spell. The loss of writing ability may present with other language or neuro ...

; the lesion is in the splenium of the corpus callosum.

Signs and symptoms

Peripheral Territory Lesions # Contralateral

homonymous hemianopsia Hemianopsia, or hemianopia, is a visual field loss on the left or right side of the vertical midline. It can affect one eye but usually affects both eyes. Homonymous hemianopsia (or homonymous hemianopia) is hemianopic visual field loss on the s ...

# cortical blindness with bilateral involvement of the occipital lobe branches #

visual agnosia Visual agnosia is an impairment in recognition of visually presented objects. It is not due to a deficit in vision (acuity, visual field, and scanning), language, memory, or intellect. While cortical blindness results from lesions to primary visua ...

# prosopagnosia #

dyslexia Dyslexia (), previously known as word blindness, is a learning disability that affects either reading or writing. Different people are affected to different degrees. Problems may include difficulties in spelling words, reading quickly, wri ...

Anomic aphasia Anomic aphasia, also known as dysnomia, nominal aphasia, and amnesic aphasia, is a mild, fluent type of aphasia where individuals have word retrieval failures and cannot express the words they want to say (particularly nouns and verbs). By cont ...

, color naming and discrimination problems # memory defect # topographic disorientation Central Territory Lesions # central post-stroke (thalamic) pain: spontaneous pain, dysesthesias and sensory impairments # involuntary movements:

chorea Chorea, or (rarely) choreia, () is an abnormal involuntary movement disorder, characterized by quick movements of the hands or feet. It is one of a group of neurological disorders called dyskinesias. The term ''chorea'' is derived , as the move ...

, intention tremor, hemiballismus # contralateral

hemiplegia Hemiparesis, also called unilateral paresis, is the weakness of one entire side of the body ('' hemi-'' means "half"). Hemiplegia, in its most severe form, is the complete paralysis of one entire side of the body. Either hemiparesis or hemiplegia ...

# Weber’s syndrome: occulomotor nerve palsy # Bálint's syndrome: loss of voluntary eye movements optic

ataxia Ataxia (from Greek α- negative prefix+ -τάξις rder= "lack of order") is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in e ...

, asimultagnosia (inability to understand visual objects)

Diagnosis

1.CT 2.MRI

Treatment

References

External links

{{Lesions of spinal cord, brainstem, and cortex Types of stroke Syndromes