What are the visual symptoms of posterior cerebral artery (PCA) stroke?

Updated: Jul 30, 2018
  • Author: Erek K Helseth, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Because many individuals identify stroke with motor weakness or language loss, they may delay seeking medical care after experiencing only vision change or headache, unaware that a stroke has occurred.

Patients may report bumping into objects, hitting obstacles on the roadside, or not seeing half the printed page when reading.

Small, homonymous visual-field cuts often are mistaken for a loss or change of vision from 1 eye, attributable to a refractive error that is correctable with glasses.

A person with a hemifield visual loss and headache also may be discharged from urgent care with a diagnosis of migraine headache rather than of PCA stroke. A computed tomography (CT) scan easily can differentiate between both conditions. Additionally, a migraine is characterized by a moving, scintillating scotoma, not a fixed, bilateral, homonymous field cut.

The presence of homonymous hemianopia also helps in differentiating between a middle cerebral artery and PCA stroke, as profound hemiplegia or somatosensory loss may occur in both conditions.


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