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Colegio de Medicina Interna de México.

2021, Number 5

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Med Int Mex 2021; 37 (5)

Posterior cerebral infarction mimicking anterior stroke

Andrade-Castellanos CA, Avilés-Estrada JA, Carreón-Bautista EE

Language: Spanish
References: 10
Page: 857-860
PDF size: 212.92 Kb.


ABSTRACT

Background: Posterior cerebral artery infarction simulates middle cerebral artery infarction in approximately 17% of patients. The distinction is difficult when the hemiplegia is not associated with symptoms indicating a midbrain lesion. Occlusion of the proximal posterior cerebral artery results in paramedian and anterolateral midbrain infarction. Paramedian infarction results in oculomotor and pupillary disturbances, while anterolateral midbrain infarction results in hemiplegia. Distinguishing between these two infarctions is important given the potential implications for treatment and outcome.
Clinical case: A 67-year-old male patient with the clinical expression of Weber syndrome –which is a crossed or alternating clinical syndrome– as part of a proximal occlusion of the posterior cerebral artery.
Conclusions: It is essential to consider the existence of a posterior cerebral artery infarction in patients with acute hemiparesis-hemiplegia associated with oculomotor abnormalities, drowsiness, and variations in the level of consciousness.


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