Dense posterior cerebral artery sign

Case contributed by Dr Aneta Kecler - Pietrzyk

Presentation

Left-sided upper and lower limb sensation loss associated with visual disturbances.

Patient Data

Age: 50 years
Gender: Male

Urgent non-contrast CT brain did not demonstrated any cortical infarct however dense right posterior cerebral artery (P1 segment) was noted.

Subsequent CTA showed occlusion of P1 posterior cerebral artery.

Repeat 24 hours non-contrast CT demonstrated acute cortical ischaemic changes within right parietooccipital lobe and thalamus with associated oedema and posterior horn of the right lateral ventricle and sulci effacement. 

Case Discussion

The posterior cerebral artery supplies the parietoocipital, occipital and inferior temporal lobe cortex along with thalami and basal nuclei.

Posterior cerebral artery occlusion incidence is much lower than anterior circulation and even less commonly is the dense PCA sign seen in practice. 

It is crucial to add presumed location of PCA on non-contrast CT brain to the routine check list.

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Case information

rID: 52271
Case created: 30th Mar 2017
Last edited: 11th Jun 2017
Inclusion in quiz mode: Included

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