From the Research
No, a right-sided facial droop is not part of the symptom constellation of a left posterior cerebral artery (PCA) stroke. Facial weakness or drooping typically occurs with middle cerebral artery (MCA) strokes, not PCA strokes. Left PCA strokes commonly present with right-sided visual field defects (right homonymous hemianopia), visual processing deficits, color anomia, and sometimes memory impairment if the medial temporal lobe is affected. The PCA primarily supplies the occipital lobe, parts of the temporal lobe, and portions of the thalamus. The facial motor cortex is located in the lateral aspect of the precentral gyrus, which is supplied by the MCA. Therefore, facial weakness is associated with MCA territory strokes rather than PCA strokes. Understanding the vascular territories and their corresponding neurological deficits is crucial for accurate stroke localization and appropriate management in clinical practice, as highlighted in a recent review on the diagnosis and management of transient ischemic attack and acute ischemic stroke 1. It's also important to note that other conditions, such as Miller Fisher syndrome, can present with facial droop, but this is not typically associated with PCA strokes 2. In terms of stroke diagnosis and management, it's essential to consider the specific vascular territory involved and the corresponding neurological deficits, rather than relying on a single symptom or sign 3, 4, 5.
Some key points to consider in the diagnosis and management of stroke include:
- The importance of prompt recognition and treatment of stroke, including the use of intravenous thrombolysis and mechanical thrombectomy in eligible patients 1
- The need to consider alternative diagnoses, such as Miller Fisher syndrome, in patients presenting with atypical stroke symptoms 2
- The importance of understanding the vascular territories and their corresponding neurological deficits in order to accurately localize and manage stroke 3, 4, 5