Posterior Cerebral Artery Infarction From Middle Cerebral Artery Infarction

Abstract

Background: While it is known that posterior cerebral artery (PCA) infarction may simulate middle cerebral artery (MCA) infarction, the frequency and localization of this occurrence are unknown. Objective: To determine the frequency of PCA infarction mimicking MCA infarction and the territory of the PCA most commonly involved in this simulation. Design: We studied 202 patients with isolated infarction in the PCA admitted to our stroke center to determine the frequency of PCA infarction simulating MCA infarction, the involved PCA territory, and the patterns of clinical presentation. Results: We found 36 patients (17.8%) with PCA ischemic stroke who had clinical features suggesting MCA stroke. The PCA territory most commonly involved was

Demographics, Risk Factors, and Etiology of Posterior Cerebral Artery Stroke Causing Homonymous Hemianopia

“…Their mean age of 60.5 years is consistent with previous publications reporting an age span of 58-73.9 years. 2,3,[5][6][7][8][9][10]12,13 The mean age of our ICA/MCA cohort at 72.3 years is also consistent with previous literature of anterior circulation ischemic stroke, which has reported mean ages between 62.7 and 76 years. 3,10,[23][24][25][26] The youth of our patients with PCA stroke also agrees with a previous study directly comparing PCA and MCA strokes.…”

“…Other determined causes of stroke in our PCA cohort accounted for 17.6% of cases, higher than the 0%–5.5% 8,9,11 reported in previous TOAST studies. Non-TOAST studies of PCA stroke have reported a range of up to 22.9%, 1–5,7,10,12,13 but with a less standardized method for how etiologic assignments were made.…”

“…29 An important finding of our study is that 40.0% of patients had a stroke of undetermined etiology. This percentage is higher than the range of 9.6%-26.9% 8,9,11 disclosed in earlier PCA stroke studies that used the TOAST criteria without the CCS calculator. Studies that did not use TOAST have reported frequencies of up to 32%.…”

“…Non-TOAST studies have reported a frequency range between 21% and 61%, [1][2][3][4][5][6][7]10,12,13 and TOAST studies have reported a range between 20% and 54.1%. 8,9,11 Other determined causes of stroke in our PCA cohort accounted for 17.6% of cases, higher than the 0%-5.5% 8,9,11 reported in previous TOAST studies. Non-TOAST studies of PCA stroke have reported a range of up to 22.9%, [1][2][3][4][5]7,10,12,13 but with a less standardized method for how etiologic assignments were made.…”

Demographics, Risk Factors, and Etiology of Posterior Cerebral Artery Stroke Causing Homonymous Hemianopia

“…Their mean age of 60.5 years is consistent with previous publications reporting an age span of 58-73.9 years. 2,3,[5][6][7][8][9][10]12,13 The mean age of our ICA/MCA cohort at 72.3 years is also consistent with previous literature of anterior circulation ischemic stroke, which has reported mean ages between 62.7 and 76 years. 3,10,[23][24][25][26] The youth of our patients with PCA stroke also agrees with a previous study directly comparing PCA and MCA strokes.…”

“…Other determined causes of stroke in our PCA cohort accounted for 17.6% of cases, higher than the 0%–5.5% 8,9,11 reported in previous TOAST studies. Non-TOAST studies of PCA stroke have reported a range of up to 22.9%, 1–5,7,10,12,13 but with a less standardized method for how etiologic assignments were made.…”

“…29 An important finding of our study is that 40.0% of patients had a stroke of undetermined etiology. This percentage is higher than the range of 9.6%-26.9% 8,9,11 disclosed in earlier PCA stroke studies that used the TOAST criteria without the CCS calculator. Studies that did not use TOAST have reported frequencies of up to 32%.…”

“…Non-TOAST studies have reported a frequency range between 21% and 61%, [1][2][3][4][5][6][7]10,12,13 and TOAST studies have reported a range between 20% and 54.1%. 8,9,11 Other determined causes of stroke in our PCA cohort accounted for 17.6% of cases, higher than the 0%-5.5% 8,9,11 reported in previous TOAST studies. Non-TOAST studies of PCA stroke have reported a range of up to 22.9%, [1][2][3][4][5]7,10,12,13 but with a less standardized method for how etiologic assignments were made.…”

Neonatal posterior cerebral artery stroke: clinical presentation, MRI findings, and outcome

“…Development of hemiplegia was rare in our cohort whereas in adults with a PCA stroke, hemiplegia has been reported in up to 18% of all patients . Development of a hemiplegia in adults is attributed to ischemia of the posterior limb of the internal capsule or of the cerebral peduncle, both involving proximal perforators of the PCA.…”

Demographics, Risk Factors, and Etiology of Posterior Cerebral Artery Stroke Causing Homonymous Hemianopia

“…Their mean age of 60.5 years is consistent with previous publications reporting an age span of 58-73.9 years. 2,3,[5][6][7][8][9][10]12,13 The mean age of our ICA/MCA cohort at 72.3 years is also consistent with previous literature of anterior circulation ischemic stroke, which has reported mean ages between 62.7 and 76 years. 3,10,[23][24][25][26] The youth of our patients with PCA stroke also agrees with a previous study directly comparing PCA and MCA strokes.…”

“…Other determined causes of stroke in our PCA cohort accounted for 17.6% of cases, higher than the 0%–5.5% 8,9,11 reported in previous TOAST studies. Non-TOAST studies of PCA stroke have reported a range of up to 22.9%, 1–5,7,10,12,13 but with a less standardized method for how etiologic assignments were made.…”

“…29 An important finding of our study is that 40.0% of patients had a stroke of undetermined etiology. This percentage is higher than the range of 9.6%-26.9% 8,9,11 disclosed in earlier PCA stroke studies that used the TOAST criteria without the CCS calculator. Studies that did not use TOAST have reported frequencies of up to 32%.…”

“…Non-TOAST studies have reported a frequency range between 21% and 61%, [1][2][3][4][5][6][7]10,12,13 and TOAST studies have reported a range between 20% and 54.1%. 8,9,11 Other determined causes of stroke in our PCA cohort accounted for 17.6% of cases, higher than the 0%-5.5% 8,9,11 reported in previous TOAST studies. Non-TOAST studies of PCA stroke have reported a range of up to 22.9%, [1][2][3][4][5]7,10,12,13 but with a less standardized method for how etiologic assignments were made.…”

Neonatal posterior cerebral artery stroke: clinical presentation, MRI findings, and outcome

“…Development of hemiplegia was rare in our cohort whereas in adults with a PCA stroke, hemiplegia has been reported in up to 18% of all patients . Development of a hemiplegia in adults is attributed to ischemia of the posterior limb of the internal capsule or of the cerebral peduncle, both involving proximal perforators of the PCA.…”

Demographics, Risk Factors, and Etiology of Posterior Cerebral Artery Stroke Causing Homonymous Hemianopia

“…Their mean age of 60.5 years is consistent with previous publications reporting an age span of 58-73.9 years. 2,3,[5][6][7][8][9][10]12,13 The mean age of our ICA/MCA cohort at 72.3 years is also consistent with previous literature of anterior circulation ischemic stroke, which has reported mean ages between 62.7 and 76 years. 3,10,[23][24][25][26] The youth of our patients with PCA stroke also agrees with a previous study directly comparing PCA and MCA strokes.…”

“…Other determined causes of stroke in our PCA cohort accounted for 17.6% of cases, higher than the 0%–5.5% 8,9,11 reported in previous TOAST studies. Non-TOAST studies of PCA stroke have reported a range of up to 22.9%, 1–5,7,10,12,13 but with a less standardized method for how etiologic assignments were made.…”

“…29 An important finding of our study is that 40.0% of patients had a stroke of undetermined etiology. This percentage is higher than the range of 9.6%-26.9% 8,9,11 disclosed in earlier PCA stroke studies that used the TOAST criteria without the CCS calculator. Studies that did not use TOAST have reported frequencies of up to 32%.…”

“…Non-TOAST studies have reported a frequency range between 21% and 61%, [1][2][3][4][5][6][7]10,12,13 and TOAST studies have reported a range between 20% and 54.1%. 8,9,11 Other determined causes of stroke in our PCA cohort accounted for 17.6% of cases, higher than the 0%-5.5% 8,9,11 reported in previous TOAST studies. Non-TOAST studies of PCA stroke have reported a range of up to 22.9%, [1][2][3][4][5]7,10,12,13 but with a less standardized method for how etiologic assignments were made.…”

Neonatal posterior cerebral artery stroke: clinical presentation, MRI findings, and outcome

“…Development of hemiplegia was rare in our cohort whereas in adults with a PCA stroke, hemiplegia has been reported in up to 18% of all patients . Development of a hemiplegia in adults is attributed to ischemia of the posterior limb of the internal capsule or of the cerebral peduncle, both involving proximal perforators of the PCA.…”