Posterior cerebral artery

Artery: Posterior cerebral artery
Outer surface of cerebral hemisphere, showing areas supplied by cerebral arteries. (Yellow is region supplied by posterior cerebral artery.)
The arterial circle and arteries of the brain. The posterior cerebral arteries (bottom forks) arise from the basilar artery (center).
Latin	arteria cerebri posterior
Gray's	subject #148 580
Supplies	occipital lobe of cerebrum
Source	basilar artery
Vein	cerebral veins
MeSH	Posterior+Cerebral+Artery

In human anatomy, the posterior cerebral artery is the blood vessel that supplies oxygenated blood to the posterior aspect of the brain (occipital lobe). It arises from the basilar artery and connects with the ipsilateral middle cerebral artery and internal carotid artery via the posterior communicating artery.

[edit] Branches

The branches of the posterior cerebral artery are divided into two sets, ganglionic and cortical:

[edit] Ganglionic branches

• The postero-medial ganglionic branches are a group of small arteries which arise at the commencement of the posterior cerebral artery: these, with similar branches from the posterior communicating, pierce the posterior perforated substance, and supply the medial surfaces of the thalami and the walls of the third ventricle.

• The posterior choroidal branches run forward beneath the splenium of the corpus callosum, and supply the tela chorioidea of the third ventricle and the choroid plexus.

• The postero-lateral ganglionic branches are small arteries which arise from the posterior cerebral artery after it has turned around the cerebral peduncle; they supply a considerable portion of the thalamus.

[edit] Cortical branches

The cortical branches are:

• the anterior temporal, distributed to the uncus and the anterior part of the fusiform gyrus
• the posterior temporal, to the fusiform and the inferior temporal gyri
• the calcarine, to the cuneus and gyrus lingualis and the back part of the convex surface of the occipital lobe
• the parietoöccipital, to the cuneus and the precuneus

[edit] Occlusion

• Contralateral loss of pain and temperature sensations.
• Visual field defects (contralateral hemianopia with macular sparing).
• Prosopagnosia with bilateral obstruction of the lingual and fusiform gyri.
• Medial Midbrain Syndrome (Weber syndrome)
• Ipsilateral deficits of Cranial Nerves V, VIII, IX, X, & XI
• Horners Syndrome

Signs and symptoms:Structures involved

[edit] Peripheral territory (Cortical branches)

• Homonymous hemianopia (often upper quadrantic): Calcarine cortex or optic radiation nearby.
• Bilateral homonymous hemianopia, cortical blindness, awareness or denial of blindness; tactile naming, achromatopia (color blindness), failure to see to-and-fro movements, inability to perceive objects not centrally located, apraxia of ocular movements, inability to count or enumerate objects, tendency to run into things that the patient sees and tries to avoid: Bilateral occipital lobe with possibly the parietal lobe involved.
• Verbal dyslexia without agraphia, color anomia: Dominant calcarine lesion and posterior part of corpus callosum.
• Memory defect: Hippocampal lesion bilaterally or on the dominant side only.
• Topographic disorientation and prosopagnosia: Usually with lesions of nondominant, calcarine, and lingual gyrus.
• Simultanagnosia, hemivisual neglect: Dominant visual cortex, contralateral hemisphere.
• Unformed visual hallucinations, peduncular hallucinosis, metamorphopsia, teleopsia, illusory visual spread, palinopsia, distortion of outlines, central photophobia: Calcarine cortex.
• Complex hallucinations: Usually nondominant hemisphere.

[edit] Central territory (Ganglionic branches)

• Thalamic syndrome: sensory loss (all modalities), spontaneous pain and dysesthesias, choreoathetosis, intention tremor, spasms of hand, mild hemiparesis: Posteroventral nucleus of thalamus; involvement of the adjacent subthalamus body or its afferent tracts.
• Thalamoperforate syndrome: crossed cerebellar ataxia with ipsilateral third nerve palsy (Claude's syndrome): Dentatothalamic tract and issuing third nerve.
• Weber's syndrome: third nerve palsy and contralateral hemiplegia: Third nerve and cerebral peduncle.
• Contralateral hemiplegia: Cerebral peduncle.
• Paralysis or paresis of vertical eye movement, skew deviation, sluggish pupillary responses to light, slight miosis and ptosis (retraction nystagmus and "tucking" of the eyelids may be associated): Supranuclear fibers to third nerve, interstitial nucleus of Cajal, nucleus of Darkschewitsch, and posterior commissure.
• Contralateral rhythmic, ataxic action tremor; rhythmic postural or "holding" tremor (rubral tremor): Dentatothalamic tract.

[edit] See also

• Circle of Willis
• Anterior cerebral artery

[edit] Additional images

The arteries of the base of the brain. Posterior cerebral artery labeled near center. The temporal pole of the cerebrum and a portion of the cerebellar hemisphere have been removed on the right side. Inferior aspect (viewed from below).

Location of cerebral cortex

Medial surface of cerebral hemisphere, showing areas supplied by cerebral arteries.

[edit] External links

• neuro/322 at eMedicine - Posterior Cerebral Artery Stroke
• Atlas of anatomy at UMich n3a8p1
• SUNY Labs 28:09-0206
• Roche Lexicon - illustrated navigator, at Elsevier 13048.000-1
• Overview at strokecenter.org
• Angiography at State University of New York Upstate Medical University
• Diagram at psyweb.com
• Blood supply at neuropat.dote.hu

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