From the Guidelines
Yes, an embolic stroke can occur in the left posterior cerebral artery (PCA). Embolic strokes happen when a blood clot or other debris forms elsewhere in the body, travels through the bloodstream, and lodges in a cerebral artery, blocking blood flow to that region of the brain. The left PCA is a potential site for embolic strokes, which can originate from cardiac sources such as atrial fibrillation, valvular heart disease, or patent foramen ovale. According to a study published in the journal Stroke 1, intravenous thrombolysis appears appropriate as first-line therapy for posterior circulation stroke, which includes the PCA. When an embolus occludes the left PCA, it can result in characteristic symptoms including:
- Contralateral homonymous hemianopia (vision loss in the right visual field)
- Visual agnosia
- Color anomia
- Sometimes memory deficits due to involvement of the left occipital lobe and potentially the left temporal lobe Treatment typically involves immediate evaluation for possible thrombolysis with tPA if within the appropriate time window (usually within 4.5 hours of symptom onset), as suggested by the study 1. Identifying and treating the underlying cause of the embolism is crucial for preventing recurrent strokes.
From the Research
Embolic Stroke in the Left Posterior Cerebral Artery
- An embolic stroke can occur in the left posterior cerebral artery, as evidenced by various studies 2, 3, 4.
- A case report describes a 36-year-old female who presented with bilateral vision loss due to a bilateral embolic posterior cerebral artery (PCA) stroke, highlighting the possibility of embolic strokes in the PCA territory 2.
- Another study discusses the interaction between hypoperfusion and embolism in posterior cerebral artery infarctions, suggesting that embolism can occur in the posterior circulation 3.
- A review of the posterior cerebral artery syndrome notes that embolic and thrombotic infarction in the PCA territory is a recognized condition, with 95% of cases consistent with embolism 4.
- The clinical presentation of PCA embolic strokes may include visual complaints, sensory deficits, and memory impairment, depending on the hemisphere involved 4.