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Posterior circulation infarct (POCI) is a type of cerebral infarction affecting the posterior circulation supplying one side of the brain.. Posterior circulation stroke syndrome (POCS) refers to the symptoms of a patient who clinically appears to have had a posterior circulation infarct, but who has not yet had any diagnostic imaging (e.g. CT Scan) to confirm the diagnosis.
The posterior circulation supplies the medulla, pons, midbrain, cerebellum and (in 70-80% of people) supplies the posterior cerebellar artery to the thalamus and occipital cortex. [1] As a result, symptoms vary widely depending which brain region is predominantly affected. The term 'vertebrobasilar insufficiency' may be used to describe disease ...
Cerebral infarction, also known as an ischemic stroke, is the pathologic process that results in an area of necrotic tissue in the brain (cerebral infarct). [1] In mid to high income countries, a stroke is the main reason for disability among people and the 2nd cause of death. [2]
FAST is less reliable in the recognition of posterior circulation stroke. [21] Other symptoms include those that indicate a rise in intracranial pressure caused by a large mass (due to hematoma expansion) putting pressure on the brain. [15] These symptoms include headaches, nausea, vomiting, a depressed level of consciousness, stupor and death. [7]
Benedikt syndrome, also called Benedikt's syndrome or paramedian midbrain syndrome, is a rare type of posterior circulation stroke of the brain, with a range of neurological symptoms affecting the midbrain, cerebellum and other related structures.
Digital subtraction angiography is the preferred imaging modality in suspected cases of primary CNS vasculitis and has greater specificity than magnetic resonance angiography or CT angiography (which have reduced accuracy for assessment of luminal irregularities of medium sized vessels or the posterior circulation of the brain). [5]
The incidence (number of cases per year) of PRES is not known, but increasing use of MRI scans has led to increased recognition. [1] [4] [5] The incidence of PRES in certain subgroups has been estimated to be approximately 0.8% in those with end stage renal disease, 0.7% in those with SLE, and 0.5% in those with a solid organ transplant. [2]
Watershed stroke symptoms are due to the reduced blood flow to all parts of the body, specifically the brain, thus leading to brain damage. Initial symptoms, as promoted by the American Stroke Association, are FAST, representing F = Facial weakness (droop), A = Arm weakness (drift), S = Speech difficulty (slur), and T = Time to act (priority of intervention).