eMedicine Specialties > Neurology > Neuro-vascular Diseases

Posterior Cerebral Artery Stroke: Follow-up

Author: Michael D Hill, MD, Medical Director, Stroke Unit, Associate Professor of Neurology, Department of Clinical Neurosciences, Foothills Hospital, University of Calgary, Canada
Coauthor(s): Alastair M Buchan, DSc, MB, BCh, Professor, Head of Medical Sciences Division, University of Oxford, UK
Contributor Information and Disclosures

Updated: Nov 10, 2009

Follow-up

Prognosis

  • The prognosis for recovery largely depends upon the location of ischemic damage.
  • Visual field deficits are unlikely to resolve.
  • Some neuropsychological deficits may improve with rehabilitation and time.

Patient Education

  • At discharge, all patients who have had a stroke should be counseled about the symptoms and signs of acute stroke.
  • Since a delay in receiving emergency care is the major reason why patients cannot be treated with thrombolytic therapy, patients must be taught what to do if a stroke occurs.
  • The major symptoms of stroke are (1) sudden loss of vision, (2) sudden loss of ability to speak or understand speech, (3) sudden weakness on one side of the body, (4) sudden loss of sensation on one side of body, and (5) sudden onset of incoordination.
  • Patients should be instructed to call an ambulance (ie, call 911) if they or their friends/relatives suffer from any of these symptoms.
  • For excellent patient education resources, visit eMedicine's Stroke Center, Cholesterol Center, and Statins Center. Also, see eMedicine's patient education article Stroke, High Cholesterol, Cholesterol FAQs, and Atorvastatin (Lipitor).

Miscellaneous

Medicolegal Pitfalls

  • Medicolegal cases involving PCA stroke are rare.
    • However, one issue that inevitably arises with infarction of the visual cortex or its afferent fibers is competency to drive a vehicle.
    • Each physician must be aware of local laws governing the right to drive. Patients with infarction in the territory of the left PCA may have preserved macular vision but severe restriction of peripheral vision as well as inability to read in any visual field.
    • Patients with infarction in the territory of right PCA may have significant visual hemineglect.
  • Careful examination and knowledge of local legal requirements is a necessity.
 


More on Posterior Cerebral Artery Stroke

Overview: Posterior Cerebral Artery Stroke
Differential Diagnoses & Workup: Posterior Cerebral Artery Stroke
Treatment & Medication: Posterior Cerebral Artery Stroke
Follow-up: Posterior Cerebral Artery Stroke
Multimedia: Posterior Cerebral Artery Stroke
References
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Further Reading

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Keywords

stroke, posterior cerebral artery stroke, vertebrobasilar insufficiency, posterior circulation stroke, PCA, PCA stroke, ischemic stroke, embolization, intrinsic atherosclerotic disease and vasospasm, migrainous strokes, PCA syndromes, paramedian thalamic infarction, cardioembolism

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Contributor Information and Disclosures

Author

Michael D Hill, MD, Medical Director, Stroke Unit, Associate Professor of Neurology, Department of Clinical Neurosciences, Foothills Hospital, University of Calgary, Canada
Michael D Hill, MD is a member of the following medical societies: Alberta Medical Association, American Academy of Neurology, American College of Physicians, American Stroke Association, Canadian Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Hoffmann La Roche Canada Ltd Honoraria Speaking and teaching

Coauthor(s)

Alastair M Buchan, DSc, MB, BCh, Professor, Head of Medical Sciences Division, University of Oxford, UK
Disclosure: Nothing to disclose.

Medical Editor

Thomas A Kent, MD, Professor, Department of Neurology, Baylor College of Medicine; Neurology Care Line Executive, Michael E DeBakey Veterans Affairs Medical Center
Thomas A Kent, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, New York Academy of Sciences, Royal Society of Medicine, Sigma Xi, and Stroke Council of the American Heart Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Howard S Kirshner, MD, Professor of Neurology, Psychiatry and Hearing and Speech Sciences, Vice Chairman, Department of Neurology, Vanderbilt University School of Medicine; Director, Vanderbilt Stroke Center; Program Director, Stroke Service, Vanderbilt Stallworth Rehabilitation Hospital; Consulting Staff, Department of Neurology, Nashville Veterans Affairs Medical Center
Howard S Kirshner, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neurorehabilitation, National Stroke Association, Phi Beta Kappa, and Tennessee Medical Association
Disclosure: Boehringer Ingelheim Honoraria Speaking and teaching; BMS/Sanofi Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching

Chief Editor

Helmi L Lutsep, MD, Professor, Department of Neurology, Oregon Health & Science University; Associate Director, Oregon Stroke Center
Helmi L Lutsep, MD is a member of the following medical societies: American Academy of Neurology and American Stroke Association
Disclosure: Co-Axia Consulting fee Review panel membership; Talecris Consulting fee Review panel membership; AGA Medical Consulting fee Review panel membership; Boehringer Ingelheim Honoraria Speaking and teaching; Concentric Medical Consulting fee Review panel membership; Abbott Consulting fee Consulting; Sanofi  Consulting

 
 
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