Posterior Cerebral Artery Stroke Differential Diagnoses

Updated: Jul 30, 2018
  • Author: Erek K Helseth, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Diagnostic Considerations

The usual differential diagnosis for posterior cerebral artery (PCA) stroke includes other vascular diseases such as intracerebral hemorrhage, cerebral venous infarction, subarachnoid hemorrhage, and subdural hemorrhage. Rarely, space-occupying lesions (eg, glioma) present as sudden onset of deficit.

Demyelinating lesions (eg, multiple sclerosis) rarely present as hemianopia, but this does occur in a few patients. Posterior reversible encephalopathy syndrome may present with visual disturbances and imaging abnormalities within the occipital lobes.

Conditions to consider in the differential diagnosis of PCA stroke include the following:

  • Basilar artery thrombosis

  • Cardioembolic stroke

  • Dissection syndromes

  • Intracranial hemorrhage

  • Mitochondrial encephalomyopathy, lactic acidosis, strokelike episodes (MELAS)

  • Multiple sclerosis

  • Brain metastases

  • Trauma

  • Infection

  • Cardiac embolism

  • Brainstem infarction

Differential Diagnoses