Fisher C M
Can J Neurol Sci. 1986 Aug;13(3):232-9. doi: 10.1017/s0317167100036337.
Embolic and thrombotic infarction in the territory of the posterior cerebral artery (PCA) is described with emphasis on the stroke and cerebrovascular features rather than special neurological syndromes. Of 47 cases of obstruction at the distal bifurcation of the basilar artery, 43 (95%) were consistent with embolism. The clinical categories and pathological findings are presented. Local embolism, vertebral distal-stump embolism, the dynamics of hemorrhagic infarction and embolus-in-transit are briefly described. The prodromal manifestations of PCA thrombotic occlusion include photopsias, hemianopic blackouts, headache, transient episodes of numbness, episodic lightheadedness, spells of bewilderment and rarely tinnitus. Recognition of these may allow prevention of a stroke. Prodromal photopsias did not closely resemble the scintillating displays of migraineurs. When the stroke occurred, visual complaints usually predominated. A sensory deficit occurred in one-third of cases. In 25 cases of memory impairment the dominant hemisphere was involved in 24. The kinds of visual hallucinations, simple and formed, are described.
本文描述了大脑后动脉（PCA）区域的栓塞性和血栓性梗死，重点在于中风和脑血管特征，而非特殊的神经综合征。在47例基底动脉远端分叉处阻塞的病例中，43例（95%）符合栓塞。文中呈现了临床分类和病理结果。简要描述了局部栓塞、椎动脉远端残端栓塞、出血性梗死的动态变化以及移行栓子。PCA血栓形成性闭塞的前驱表现包括闪光幻觉、偏盲性黑矇、头痛、短暂性麻木发作、发作性头晕、困惑发作，很少有耳鸣。认识到这些表现可能有助于预防中风。前驱性闪光幻觉与偏头痛患者的闪烁视觉表现并不十分相似。中风发生时，视觉症状通常占主导。三分之一的病例出现感觉障碍。在25例记忆障碍病例中，24例优势半球受累。文中描述了简单和成形的各种视幻觉。
