Posterior Cerebral Artery Infarction from Vertebral Artery Dissection

Update item information
Identifier EEC-PCA Infarction
Title Posterior Cerebral Artery Infarction from Vertebral Artery Dissection
Subject cerebral infarction, vertebral artery dissection, homonymous hemianopia, posterior cerebral artery occlusion, MRI, DWI, ADC, MRA
Creator Kristen Hudson, MD, Emory Eye Center Atlanta, Georgia; Valerie Biousse, MD, Emory Eye Center Atlanta, Georgia
Description Right posterior cerebral artery ischemic infarction due to post traumatic (martial arts) left vertebral artery dissection with resulting right PCA occlusion. Left homonymous hemianopia due to right occipital lobe infarction and left hemisensory loss due to right thalamic infarction. Imaging of the acute infarct on MRI and of the old infarct on CT; vascular imaging on MRA. Figure 1 : Complete Left Homonymous Hemianopia on Humphrey visual fields (a: left eye; b: right eye) Figures 2 to 5:Brain MRI (performed 8 hours after symptom onset). a : Diffusion Weighted Images (DWI) and b : Apparent Diffusion Coefficient (ADC). Note the hyperintense (bright) areas on DWI (red arrows) with corresponding dark on ADC (green arrows) indicating acute infarction in right PCA territory (occipital and inferior temporal lobes) Figure 6 : MRA of the head with contrast (Source Images). Note the lack of flow-related signal in left VA (green circle), with minimal signal visualized in only most proximal VA (green arrows) near vertebrobasilar junction. Normal flow-related signal in bilateral ICAs and right VA (red arrows). Figure 7 : MRA of the head with contrast (Source Images). The right PCA (red arrows) is visualized at its takeoff from basilar artery (yellow arrow) with initial flow-related signal, followed by loss of signal (red circle). Left PCA visualized on all slices for comparison (blue arrows). Figure 8 : MRA Head with contrast (3D reconstructions). Note lack of visualization of the left VA (green arrows) and right PCA (red arrow) compared to normal (dominant) right VA and left PCA (blue arrow). Figure 9 : Head CT without contrast (2.5 weeks later). Hypodensity (red arrows) in right occipital and inferior temporal lobes corresponding to old infarction (2.5 weeks) Figure 4 : Post-
Contributor Primary Hudson, Kristen
Contributor Secondary Biousse, Valerie
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Type Image
Format application/pdf
Rights Management Copyright 2014. For further information regarding the rights to this collection, please visit:
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s65t6h35
Setname ehsl_novel_eec
Date Created 2014-04-10
Date Modified 2018-01-22
ID 177365
Reference URL
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