Comparison of Clinical, Radiological and Outcome Characteristics of Ischemic Strokes in Different Vascular Territories

Ashraf V Valappil, Dhanya T Janardhanan, Praveenkumar Raghunath, Abdulla Cherayakkat, Girija AS

Abstract


Background: Ischemic strokes are usually characterized by their etiology and the affected brain territory defined by the vascular supply. Strokes located within posterior circulation are considered by some as a condition with high morbidity and mortality. Recent findings suggest that stroke etiologies of posterior circulation strokes (PCS) and anterior circulation strokes (ACS) are more alike than dissimilar, suggesting that PCS deserve same investigations as ACS. The clinical and radiological characteristics and outcome between patients with PCS and ACS were compared.

Methods: Two hundred and twenty-two consecutive ischemic stroke patients with ACS and 81 patients with PCS were prospectively analysed.

Results: Patients with ACS and PCS did not differ in terms of demographic characteristics. Mean age in ACS group was 65 yrs and PCS group was 60 yrs. Prevalence of vascular risk factors like hypertension, diabetes, dyslipidemia, coronary artery disease, smoking, past history of stroke/TIA did not differ in two groups except for hypertension. The mean National Institute of Health Stroke score (NIHSS) at admission was 11 in ACS and 8 in PCS (P = 0.04). Brain imaging revealed pathological findings more in ACS group than PCS (CT, 72% vs. 67%; MRI, 90% vs. 80%). Cardioembolic stroke was more frequently seen in ACS than PCS (11% vs. 6%). IV thrombolysis was done in 9 patients with ACS and 3 patients with PCS. The proportion of patients with good clinical outcome (modified Rankin score 0 - 2) was similar in ACS and PCS (43% vs. 46% respectively, P = 0.46).

Conclusions: Demographic characteristics, etiology and outcome are more alike than different in posterior circulation strokes and anterior circulation strokes.




doi: http://dx.doi.org/10.4021/jnr229w


Keywords


Ischemic stroke; Posterior circulation stroke; Anterior circulation stroke; Comparison; Prognosis

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