Clinical syndromes large vessel occlusion


Basilar ... artery

Posterior cerebral artery

Temporal branch

Occipital branch i

Cerebral Temporal Calcarine peduncle branch branch

Medial surface of right hemisphere

Calcarine branch

Undersurface of left cerebral hemisphere

Perforating vessels

— Occipital branch

The posterior cerebral arteries are the terminal branches of the basilar artery. Small perforating branches supply midbrain structures, choroid plexus and posterior thalamus. Cortical branches supply the undersurface of the temporal lobe - temporal branch; and occipital and visual cortex - occipital and calcarine branches.

Clinical features

Proximal occlusion by thrombus or embolism will involve perforating branches and structures supplied:

Midbrain syndrome - III nerve palsy with contralateral hemiplegia - WEBER'S SYNDROME. Thalamic syndromes - chorea or hemiballismus with hemisensory disturbance.

Occlusion of cortical vessels will produce a different picture with visual field loss (homonymous hemianopia) and sparing of macular vision (the posterior tip of the occipital lobe, i.e. the macular area, is also supplied by the middle cerebral artery).

Posterior cortical infarction in the dominant hemisphere may produce problems in naming colours and objects.

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