Clinical Features and Rehabilitation of Strokes in the Less Common Vascular Territories: Anterior and Posterior Cerebral Artery Strokes

Abstract

Stroke is a common and important clinical condition encountered in rehabilitation. However, anterior cerebral artery (ACA) and posterior cerebral artery (PCA) stroke are the less frequently managed stroke subtypes due to their lower incidence compared to strokes in other vascular territories. Despite this, both ACA and PCA stroke present with cognitive, sensory, and motor impairments not found in other stroke groups. These include akinetic mutism, alien-hand syndromes, and the callosal disconnection syndromes in ACA stroke, as well as various visual impairments, central poststroke pain, and dyslexia syndromes seen in PCA stroke. Many of the common impairments seen in general stroke rehabilitation such as behavioral, balance, and continence disorders manifest in different, unique presentations that are often unrecognized. In this review, we focus on the specific clinical signs, symptoms, and resultant impairments and disabilities that occur in ACA and PCA stroke. We also discuss and summarize recent developments in rehabilitation interventions and therapeutics aimed at alleviating the significant disability posed by these less commonly seen stroke disorders. Finally, we report the functional outcomes of ACA and PCA stroke and compare them with strokes in other vascular territories. Encouragingly, patients with ACA and PCA stroke make significant functional gains with a comprehensive, holistic, and individualized stroke rehabilitation program.