What is the role of rehabilitation in the management 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

Patients with posterior cerebral artery (PCA) stroke experience a dramatic alteration of visual function, requiring modification of ADL. Homonymous field loss makes these patients prone to burns, motor vehicle accidents, mechanical injury from falls, and walking into objects. Explain these risks clearly to the patient and his/her family. Do not allow driving until follow-up evaluations of visual-field loss have been completed and occupational therapists and clinicians have tested the patient for visual function. The patient must learn conscious scanning into the visual-field deficit.

The hemiparetic patient who has sustained a posterior cerebral artery (PCA) stroke must learn transfer techniques, walking with mechanical assistance (if feasible), and modified ADL (eg, dressing, bathing, cooking). Some patients require a significant amount of assistance. The patient's caregiver should meet with therapists to learn how best to help the patient at home without causing personal or other injury.

Depending on the degree of motor loss, available insurance coverage, and other variables, such as social situation, the patient may qualify for continued outpatient or home therapy.


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