INFARCTS IN THE AREA OF THE POSTERIOR CER EBRAL-ARTERY - CLINICAL-FEATURES, PATHOGENESIS, AND PROGNOSIS

The clinical and neuroradiological features of 127 patients with ische mia of the posterior cerebral artery (PCA) and a positive CT scan (n = 122) or pathological angiography findings (n = 63) were analyzed. Uni lateral headache was the most common presenting symptom (50%), making complicated migraine an important differential diagnosis. Clinical fin dings were visual field deficits (93%), sensory (29%), motor (28%), an d neuropsychological deficits (25%). Infarcts, including the thalamus (n = 27), were mostly associated with sensory and slight motor deficit s. Our findings suggest that motor deficits in PCA ischemia, particula rly if minor and reversible, are Likely to be due to ischemia-induced edema in the internal capsule adjacent to an associated thalamic infar ct. Based on angiography, stroke etiology was considered embolic in 83 /127 (65%), atherothrombotic in 20/126 (16%), and probably migrainous in 4 (3%) patients. In the remaining 20 patients (16%), the etiology w as uncertain. Prognosis of PCA infarcts is usually good.