posterior cerebral artery

後大脳動脈 PCA

WordNet

1. of or relating to the cerebrum or brain; "cerebral hemisphere"; "cerebral activity"
2. involving intelligence rather than emotions or instinct; "a cerebral approach to the problem"; "cerebral drama" (同)intellectual
3. located at or near or behind a part or near the end of a structure
4. a major thoroughfare that bears important traffic
5. a blood vessel that carries blood from the heart to the body (同)arteria, arterial blood vessel

PrepTutorEJDIC

1. 大脳の,脳の / 頭脳的な,知的な
2. 《名詞の前にのみ用いて》(生物学的に,位置が)後ろの,後部の / (時間・順序が)後の;(…より)後の《+『to』+『名』》(later) / しり(buttocks)
3. 動脈 / (道路・水路・鉄道などの)勘線,(通信の)主チャンネル

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/04/20 21:13:17」(JST)

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[Wiki en表示]

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).
Details
Source	basilar artery (most common in adults)
Vein	cerebral veins
Supplies	occipital lobe of cerebrum
Identifiers
Latin	arteria cerebri posterior
MeSH	A07.231.114.228.700
Dorlands /Elsevier	a_61/12153821
TA	A12.2.07.082
FMA	50583
Anatomical terminology [edit on Wikidata]

The posterior cerebral artery (PCA) is one of a pair of blood vessels that supply oxygenated blood to the posterior aspect of the brain (occipital lobe) in human anatomy. It arises near the intersection of the posterior communicating artery and the basilar artery and connects with the ipsilateral middle cerebral artery (MCA) and internal carotid artery via the posterior communicating artery (PCommA).

Origin

The development of the PCA in fetal brain comes relatively late and arises from the fusion of several embryonic vessels near the caudal end of the PCommA supplying the mesencephalon and diencephalon of the fetus. The PCA begins as such, as a continuation of the PCommA in the fetus with only 10–30% of fetuses having a prominent basilar origin.

The fetal carotid origin of the PCA usually regresses as the vertebral and basilar arteries develop with the PCommA reducing is size. In most adults, the PCA sources from the anterior portion of the basilar artery. Only about 19% of adults retain PCommA dominance of the PCA with 72% having dominant basilar origin, and the rest having either equal prominence between PCommA and basilar artery, or a single exclusive source.

Structure

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

Central branches

See also: Artery of Percheron

Also known as the perforating branches:

• Thalamoperforating and thalamogeniculate or postero-medial ganglionic branches: 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.
• Peduncular perforating or postero-lateral ganglionic branches: 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.

Posterior cerebral artery

(Posterior) choroidal branches (occasionally referred to as a single artery, the posterior choroidal artery)

Not to be confused with the Anterior choroidal artery

• Medial 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.
• Lateral posterior choroidal branches: small branches to the cerebral peduncle, fornix, thalamus, caudate nucleus, and choroid plexus of the lateral ventricle.

Cortical branches

The cortical branches are:

• Anterior temporal, distributed to the uncus and the anterior part of the fusiform gyrus
• Posterior temporal, to the fusiform and the inferior temporal gyri
• Lateral occipital, which branches into the anterior, middle and posterior inferior temporal arteries
• Medial occipital, which branches into the:
  • Calcarine, to the cuneus and gyrus lingualis and the back part of the convex surface of the occipital lobe
  • Parieto-occipital, to the cuneus and the precuneus
• Splenial, or the posterior pericallosal branch, sometimes anastamoses with the anterior cerebral artery (ACA), and may not be present if the ACA wraps around the corpus callosum

Clinical relevance

Stroke

• 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.
• Superior Alternating Syndrome (Weber's syndrome)
• Ipsilateral deficits of oculomotor nerve,
• Contralateral deficits of facial nerve (only lower face, upper face receives bilateral input), vagus nerve and hypoglossal nerve
• Horner's Syndrome

Signs and symptoms:Structures involved

See: Posterior cerebral artery syndrome

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.

Central territory (Ganglionic branches)

• Thalamic syndrome: sensory loss (all modalities), spontaneous pain and dysesthesias, choreoathetosis, intention tremor, spasms of hand, mild hemiparesis, contralateral hemianaethesia: 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.

See also

This article uses anatomical terminology; for an overview, see Anatomical terminology.

• Circle of Willis
• Anterior cerebral artery

Additional images

Medial surface of cerebral hemisphere, showing areas supplied by cerebral arteries. Areas supplied by the posterior cerebral artery shown in yellow.  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).

References

External links

• neuro/322 at eMedicine – Posterior cerebral artery stroke
• Atlas image: n3a8p1 at the University of Michigan Health System
• Anatomy photo:28:09-0206 at the SUNY Downstate Medical Center
• Anatomy diagram: 13048.000-1 at Roche Lexicon - illustrated navigator, Elsevier
• Overview
• Angiography at State University of New York Upstate Medical University
• Diagram
• Blood supply

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 後方循環系の脳血管症候群 posterior circulation cerebrovascular syndromes
• 2. 頸動脈内膜剥離術および頸動脈ステント留置術の麻酔 anesthesia for carotid endarterectomy and carotid stenting
• 3. 悪性中大脳動脈領域梗塞に対する減圧開頭術 decompressive hemicraniectomy for malignant middle cerebral artery territory infarction
• 4. 急性虚血性脳卒中に対する再灌流療法 reperfusion therapy for acute ischemic stroke
• 5. 頚動脈狭窄の評価 evaluation of carotid artery stenosis

English Journal

• Intraprocedural retrieval of migrated coils during endovascular aneurysm treatment with the Trevo Stentriever device.

• Liu KC1, Ding D2, Starke RM2, Geraghty SR3, Jensen ME4.Author information 1University of Virginia, Department of Neurological Surgery, P.O. Box 800212, Charlottesville, VA 22908, USA; University of Virginia, Department of Radiology, Charlottesville, VA, USA. Electronic address: kenneth.c.liu@virginia.edu.2University of Virginia, Department of Neurological Surgery, P.O. Box 800212, Charlottesville, VA 22908, USA.3Advocate Medical Group, Department of Neurointerventional Surgery, Park Ridge, IL, USA.4University of Virginia, Department of Radiology, Charlottesville, VA, USA.AbstractCoil migration during endovascular treatment of intracranial aneurysms occurs in 2-6% of cases. As endovascular coiling of aneurysms has become increasingly popular and as endovascular technology continues to rapidly evolve, the prevalence of intraprocedural coil migration will invariably rise. Since coil masses are highly thrombogenic, migration out of the aneurysm sac into the parent artery may result in large territory infarcts which subsequently manifest as significant neurological morbidity. Therefore safe and timely retrieval of migrated coils is essential to avoiding poor angiographic and clinical outcomes. A 66-year-old woman with an unruptured 5×3mm, wide-necked posterior communicating artery aneurysm was referred for endovascular treatment. During coiling with the dual catheter technique, both initially deployed coils dislodged from the aneurysm sac and migrated distally into the middle cerebral artery. After failed retrieval with an Alligator device (Chestnut Medical Technologies, Menlo Park, CA, USA), we used two Trevo devices (Concentric Medical, Mountain View, CA, USA) in succession to successfully retrieve the migrated coils. The aneurysm was then occluded with stent-assisted coil embolization. There were no post-procedural angiographic or clinical complications. The patient was subsequently discharged home without neurological deficit. This case illustrates the first use of the Trevo device for retrieval of migrated coils during endovascular treatment of an intracranial aneurysm to our knowledge. Due to the lack of guidelines defining the standard management of intraprocedural coil migration, current strategies are based on retrospective review of published reports and expert opinion. We present a unique and effective method for endovascular retrieval of displaced coils using a Trevo Stentriever device.
• Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia.J Clin Neurosci.2014 Mar;21(3):503-6. doi: 10.1016/j.jocn.2013.10.012. Epub 2013 Oct 30.
• Coil migration during endovascular treatment of intracranial aneurysms occurs in 2-6% of cases. As endovascular coiling of aneurysms has become increasingly popular and as endovascular technology continues to rapidly evolve, the prevalence of intraprocedural coil migration will invariably rise. Sinc
• PMID 24332812

• Extended subtemporal transtentorial approach to the anterior incisural space and upper clival region: experience with posterior circulation aneurysms.

• McLaughlin N, Martin NA.Author information Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California.AbstractBACKGROUND: Although most posterior circulation aneurysms are currently treated by endovascular means, some are not amenable to this treatment modality. The narrow working window afforded by the anterolateral and lateral surgical approaches often translates into suboptimal visualization and limited maneuverability.
• Neurosurgery.Neurosurgery.2014 Mar;10 Suppl 1:15-24. doi: 10.1227/NEU.0000000000000175.
• BACKGROUND: Although most posterior circulation aneurysms are currently treated by endovascular means, some are not amenable to this treatment modality. The narrow working window afforded by the anterolateral and lateral surgical approaches often translates into suboptimal visualization and limited
• PMID 24064480

• Changing treatment strategy from clipping to radial artery graft bypass and parent artery sacrifice in patients with ruptured blister-like internal carotid artery aneurysms.

• Kazumata K, Nakayama N, Nakamura T, Kamiyama H, Terasaka S, Houkin K.Author information *Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan ‡Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan §Sapporo Teishinkai Hospital, Sapporo, Hokkaido, Japan.AbstractBACKGROUND: Blood blister-like aneurysms (BBAs) are aneurysms with ill-defined fragile necks arising from an internal carotid artery (ICA) and associated with high mortality.
• Neurosurgery.Neurosurgery.2014 Mar;10 Suppl 1:66-73. doi: 10.1227/NEU.0000000000000076.
• BACKGROUND: Blood blister-like aneurysms (BBAs) are aneurysms with ill-defined fragile necks arising from an internal carotid artery (ICA) and associated with high mortality.OBJECTIVE: To describe strategies and outcomes in patients in whom radial artery (RA) graft bypass with ICA sacrifice was cons
• PMID 23842547

Japanese Journal

• CLINICAL INVESTIGATION : Reduced retinal ganglion cell complex thickness in patients with posterior cerebral artery infarction detected using spectral-domain optical coherence tomography

• Yamashita Tsutomu,Miki Atsushi,Iguchi Yasuyuki [他]
• Japanese journal of ophthalmology : the official English-language journal of the Japanese Ophthalmological Society 56(5), 502-510, 2012-09
• NAID 40019415431

• 側頭葉内側の動脈と手術における留意点(<特集>側頭葉とその周辺の解剖と手術I-第25回微小脳神経外科解剖セミナー合同セッションより-)

• 川合 謙介,斉藤 延人
• 脳神経外科ジャーナル 21(8), 594-603, 2012-08-20
• てんかんや脳腫瘍など側頭葉内側病変に対する手術では,側頭葉内側血管系の理解が重要である.前脈絡叢動脈は鉤上部表面に沿って後走し脈絡叢に入る.その脳槽部から分岐する鉤枝は鉤溝に入り海馬動脈と吻合する.重要な穿通枝である内包視床動脈は脈絡叢に入る直前または直後で分岐する.鉤切除の際は,軟膜下に進めれば前脈絡叢動脈損傷のリスクは少ないが,後方では脈絡叢の内側を走行する穿通枝に注意が必要である.また,上外 …
• NAID 110009480318

Related Links

• Posterior Cerebral Artery | neuroangio.org

Supply of the Cerebral Peduncle and Quadrigeminal Plate — Collicular (Quadrigeminal) Artery and Variants The P2 segment of the PCA swings around the cerebral peduncle, underneath the thalamus, towards the quadrigeminal plate ...

• Posterior Cerebral Artery Stroke: Background, Anatomy ...

Posterior cerebral artery (PCA) stroke is less common than stroke involving the anterior circulation. An understanding of PCA stroke phenomenology and mechanisms requires knowledge of neurovascular anatomy and of ...

Related Pictures

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★リンクテーブル★

リンク元	「後大脳動脈」「PCA」
関連記事	「posterior」「cerebral」

「後大脳動脈」

　　[★]

英

posterior cerebral artery (KH), PCA

ラ

arteria cerebri posterior

関

前大脳動脈、中大脳動脈

• 図：KH.347(分布域) M.488(分布域) N.132-135

起始

• 脳底動脈

走行

• 橋と側頭葉の間に潜り込んでいく
• 脳底動脈から分岐後、前方に向かって後交通動脈を分枝し、大脳脚の外側に沿って後方に向かう。この間、側頭葉の内側縁に沿って走行する (KH.347 KL.765の図から想像)

分布

• 側頭葉の先端を除く内部、側頭葉の外側面の下半分。後頭葉の外表面と内部の全て。頭頂葉のうち後頭葉寄りの外部と内部 (KH.347 KL.765の図から想像)

枝

1. ref(artery_cerebral_base.png,大脳動脈)

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「PCA」

　　[★]

• 受動皮膚アナフィラキシー passive cutaneous anaphylaxis
• patient-controlled analgesia
• 後大脳動脈 posterior cerebral artery

同

patient-controlled analgesia

「posterior」

　　[★]

• adj.

• 後側の、後方の、後の

関

after、afterward、afterwards、backward、behind、following、late、post、posteriorly、subsequent

　 　

「cerebral」

　　[★]

• adj.

• 大脳の、大脳性の、脳性の、脳の

関

brain、cerebri、cerebro、cerebrum、encephalic、encephalo、encephalon