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Posterior Cerebral Artery

arteria cerebri posterior

The posterior cerebral artery supplies the primary visual cortex in the occipital lobe via the calcarine artery, making PCA territory infarction the cause of homonymous hemianopia — loss of the contralateral visual field in both eyes. The macular (central) vision is characteristically spared in PCA infarction because the occipital tip receives dual blood supply from both PCA and MCA. Cortical blindness from bilateral PCA infarction produces total loss of vision with intact pupillary responses.

Region: Head & Skull

Anatomical Data

Origin, Insertion & Supply

Origin	Terminal bifurcation of the basilar artery

Clinical Relevance

Clinical Notes

PCA strokes produce the classic contralateral homonymous hemianopia with macular sparing, often without the motor or language deficits that characterise MCA strokes, making them easier to miss. CN III palsy from posterior communicating artery aneurysm occurs because the PCA origin is adjacent to the PCOM artery. The posterior thalamic perforators from the PCA supply the thalamus, and thalamic infarction produces contralateral hemisensory loss and thalamic pain syndrome.

Pathology

Common Injuries & Conditions

PCA Territory Stroke

Posterior cerebral artery infarction producing contralateral homonymous hemianopia with macular sparing, identified by MRI diffusion-weighted imaging and managed with acute stroke pathway treatment.