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Medicine (MD/DO)
USMLE Step 1
Neurology, Ophthalmology & Otology
Ischemic Brain Disease (Stroke)
PCA Stroke

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PCA Stroke

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Types of Strokes
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Middle Cerebral Artery
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Left Hemisphere Stroke Assessment
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Right Hemisphere Stroke Assessment
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Anterior Cerebral Artery

PCA Stroke

Post-terrier Brain Artery-archer Stroke-crew
Contralateral Homonymous Hemianopia with Macular Sparing
Opposite-sided Half-nope-eyes and Macula-Dracula

If the primary visual cortex in the occipital lobe is affected, the patient will present with contralateral homonymous hemianopia with macular sparing. This sparing is thanks to the collateral branches of the MCA that also irrigate the region of the macula.

Cortical Blindness
Cortez with Blinds-over-eyes

When there is bilateral damage to the occipital cortex, the patient develops cortical blindness without awareness of their deficit and possible confabulation.

Thalamic Pain Syndrome
Thor in Pain

When the thalamus is affected, the patient develops contralateral hemibody pain, allodynia, and hyperalgesia, also known as thalamic pain syndrome.

Dorsal Midbrain Syndrome
Dorsal-fin Middle-brain

Pinealomas are the most common cause of dorsal midbrain lesion, but they can also be caused by a PCA stroke. Vertical gaze palsy, nystagmus, the collier sign, and pseudo-Argyll Robertson pupils are among the symptoms.

Contralateral Hemiparesis and Hemisensory Loss
Opposite-sided Half-side Droopy Muscle and Half-sensor Broken

Hemispheric damage in a PCA stroke can cause contralateral hemiparesis and hemisensory loss.


It is important to remember that the corpus callosum allows visual input to reach the parietal cortex language centers, integrating visual signals to produce language. When there is a PCA infarct in the left hemisphere (usually the dominant hemisphere), the patient will present with dyslexia.

Alexia without Agraphia

Another possible manifestation of a PCA stroke in the left hemisphere, in the area of the splenium of the corpus callosum, is alexia without agraphia (the patient can write but not read).

A-fish with Aphasia

When a large stroke occurs in the left hemisphere, which is usually the dominant hemisphere, in PCA territory, aphasia can happen.

Amnesia and Confusion
Memory-eraser and Confucius

When it comes to the hippocampus, a PCA stroke on one or both sides can cause memory loss and confusion.

Can't Recognize Faces (Prosopagnosia)
Unrecognizable Faces

When the corpus callosum in the right hemisphere (usually the non-dominant side) is affected by a PCA stroke, the patient will have prosopagnosia, which means they won't be able to recognize familiar faces.


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