Presentation
Left-sided upper and lower limb sensation loss associated with visual disturbances.
Patient Data
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 ischemic changes within right parietooccipital lobe and thalamus with associated edema 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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