Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Posterior Circulation PowerPoint PPT presentation
There are two clinical syndromes commonly observed with occlusion of the PCA:
P1 syndrome with midbrain, subthalamic, and thalamic signs, which are due to
occlusion of the proximal P1 segment of the PCA or its penetrating branches
P2 syndrome with cortical temporal and occipital lobe signs, due to
occlusion of the P2 segment distal to the junction of the PCA with
the posterior communicating artery.
P1 SYNDROMES
CLAUDES SYNDROME
WEBER'S SYNDROME
DEJERINE ROUSSY SYNDROME
P2 SYNDROMES
ANTONS SYNDROME
BALINTS SYNDROME
CLAUDE SYNDROME
Occlusion of small perforating branches of PCA supplying the dorsomedial
aspect of the midbrain
Infarction involves the medial aspect of red nucleus with the rubrodendate
fibres, CN III nucleus and superior cerebellar peduncle
Ipsilateral third nerve palsy
Contralateral upper and lower limb ataxia
WEBER SYNDROME
Also known as superior alternating hemiplegia
Occlusion of paramedian branches of PCA that supplies the midbrain
Contralateral hemiplegia
Ipsilateral third nerve palsy
Dejerine Roussy syndrome
Thalamic infarction involving the VPL Nucleus
contralateral hemisensory loss followed later by a burning pain in the affected
areas.
It is persistent and responds poorly to analgesics.
Anticonvulsants (carbamazepine or gabapentin) or tricyclic antidepressants
may be beneficial.
Anton's syndrome
Bilateral infarction in the distal PCA segments
produces cortical blindness (blindness with preserved pupillary light reaction).
The patient is often unaware of the blindness or may even deny it.
Rarely, only peripheral vision is lost and central vision is spared, resulting in
"gun-barrel" vision.
Balint's syndrome
Bilateral visual association area lesions usually resulting from infarctions
secondary to low flow in the "watershed" between the distal PCA and MCA
territories, as occurs after cardiac arrest.
Patients may experience persistence of a visual image for several minutes
despite gazing at another scene (palinopsia) or an inability to synthesize the
whole of an image (asimultanagnosia)
LOCKED- IN SYNDROME
Due to occlusion of BASILAR ARTERY supplying ventral pons
MANIFESTATIONS:
quadriplegia
weakness of face
dysarthria
If the lesion is big, there will be horizontal gaze weakness due to involvement
of fascicles of bilateral abducent nerves.
Patients are literally locked in their bodies due to their difficulty to move,
speak and express emotions even though they are fully conscious.
MILLARD GUBLER SYNDROME
Occurs secondary to stenosis of paramedian and short circumferential
branches of basilar artery
Area involved is the ventral aspect of pons including the fibers of corticospinal
tract, VI and the VII Cranial nerves.
COMPONENTS:
ipsilateral weakness of the eye on abduction (involvement of CN VI)
ipsilateral facial muscle weakness
contralateral hemiplegia
RAYMOND ? FOVILLE SYNDROME
Due to occlusion of paramedian branches of basilar artery supplying ventral
medial pons.
COMPONENTS:
ipsilateral lateral rectus paresis due to CN VI involvement
contralateral hemiplegia
BENEDIKT'S SYNDROME
Occlusion of branches of posterior cerebral artery supplying the fascicles of
oculomotor nerve and red nucleus
Ipsilateral third nerve palsy, crossed hemiataxia and crossed choreoathetosis
NOTHNAGEL SYNDROME
Rare midbrain stroke syndrome that involves tectum of midbrain
Involves fascicles of CN III and superior cerebellar peduncle
Ipsilateral third nerve palsy and contralateral limb ataxia
LABYRYNTHINE ARTERY SYNDROME
Due to ischemia of labyrinthine artery
Sudden tinnitus, vertigo and ipsilateral deafness
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This post was last modified on 12 August 2021