How should the evaluation of posterior cerebral artery (PCA) stroke be approached initially?

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

Reviewing documentation and performing baseline neurologic examinations help the clinician to recognize an evolving or recurring stroke, which is treatable, from a completed infarction.

After stroke has been correctly identified and localized, the next step is to determine the mechanism by which the stroke occurred, as this will guide long-term preventive strategies. In some cases, all diagnostic possibilities need to be considered and the workup is extensive.

In other cases, however, the mechanism may be promptly suggested by the patient’s history, with a focused work-up revealing an immediate cause. An example would be a young individual with neck trauma in whom vascular imaging demonstrates a cervical artery dissection with thrombosis.


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