Middle and Posterior Cerebral Artery Infarction - Case 1

A 65 year-old woman developed the abrupt onset of a global aphasia, left gaze preference, right hemiplegia, and right visual field loss.

Show the Infarction                                       Show the MCA and PCA Territories

Middle and Posterior Cerebral Artery Infarction. Diffusion-weighted axial MRIs. (Left) - level of the midbrain; (Right) - level of the basal ganglia. Note the large infarction in the distribution of the left middle cerebral (MCA) and posterior cerebral (PCA) arteries. Such a lesion can occur from multiple emboli; however, it is more likely that a single occlusion caused this lesion. A number of individuals have a normal anatomic variant known as a persistent fetal circulation, wherein the PCA arises directly from the posterior communicating artery off the internal carotid artery. In this case, an embolus at the top of the internal carotid artery can then infarct the middle cerebral and posterior cerebral artery territories. In this case, the anterior cerebral artery territory is spared, presumably because of an intact anterior communicating artery whereby blood can flow from the contralateral side.

Revised 11/06/06
Copyrighted 2006. David C Preston