Pure superficial posterior cerebral artery territory infarction in The Lausanne Stroke Registry.

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Serval ID
serval:BIB_24969
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Pure superficial posterior cerebral artery territory infarction in The Lausanne Stroke Registry.
Journal
Journal of Neurology
Author(s)
Cals N., Devuyst G., Afsar N., Karapanayiotides T., Bogousslavsky J.
ISSN
0340-5354
Publication state
Published
Issued date
2002
Volume
249
Number
7
Pages
855-861
Language
english
Abstract
OBJECTIVE: To determine the patterns of clinical presentation, lesion topography, and etiology in patients with ischemic stroke limited to the superficial territory of the posterior cerebral artery (s-PCA). METHODS: In the Lausanne Stroke Registry (LSR, 1983-1998), we determined the patterns of clinical presentation, lesion topography and mechanisms of stroke, among 117 patients with s-PCA infarction (s-PCAI) on brain imaging. RESULTS: s-PCAIs accounted for 30.5 % of all PCA territory ischemic strokes. The presumed etiology was embolism in 64 (54.5 %) patients [cardiac in 51 (43.5 %) and arterial in 13 (11 %)], indeterminate in 38 (32 %), PCA atherothrombosis in 4 (3.4 %), migraine in 4 (3.4 %), other rare causes in 4 (3.4 %), and multiple potential sources of embolism in 3 (2.5 %). The clinical findings were hemianopsia in 78 (67 %), quadrantanopsia in 26 (22 %), and bilateral visual field defects in 8 (7 %). Motor, sensory, or sensorimotor deficits were detected in 14 (12 %), 8 (6.8 %), or 8 (6.8 %) patients, respectively. Neuropsychological dysfunction included memory impairment in 20 (17.5 %; with left [L], right [R], or bilateral [B] lesions in 15, 2, or 3 patients, respectively), dysphasia in 17 (14.5 %; L/B: 14/3), dyslexia with dysgraphia in 5 (4 %; L/B: 4/1), dyslexia without dysgraphia in 10 (8.5 %; L/B: 8/2), hallucinations in 12 (10 %; L/R/B: 5/5/2), visual neglect in 11 (9.5 %; L/R: 2/9), visual agnosia in 10 (8.5 %; L/B: 7/3), prosopagnosia in 7 (6 %; R/B: 4/3), and color dysnomia in 6 (5 %; L: 6). CONCLUSIONS: s-PCAIs are uncommon, representing less than a third of all PCA infarctions. Although embolism is the main cause in 60 % of patients, identification of the emboli source is often not possible. In 1/3 of cases, the stroke mechanism cannot be determined. Neuropsychological deficits are frequent if systematically searched for.
Keywords
Adult, Aged, Aged, 80 and over, Cerebral Infarction/complications, Cerebral Infarction/pathology, Female, Humans, Incidence, Intracranial Embolism/complications, Male, Middle Aged, Posterior Cerebral Artery/pathology, Registries, Stroke/physiopathology
Pubmed
Web of science
Open Access
Yes
Create date
19/11/2007 12:21
Last modification date
01/10/2019 6:17
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