Clinical - demographic characteristics of the institutional cohort of patients with ischemic stroke in the posterior territory.
DOI:
https://doi.org/10.52692/1857-0011.2022.3-74.15Keywords:
Stroke, posterior circulation, risk factors, institutional cohortAbstract
According to literature data, the prevalence of stroke in the posterior circulation represents 20 30% of all ischemic strokes. It represents a clinical syndrome associated with ischemia in the cerebral territory vascularized by the vertebrobasilar system. The most common etiologies include intrinsic atherosclerosis, cardio embolism, vertebrobasilar dolichoectasia and spontaneous or posttraumatic cervical artery dissection, subclavian steal syndrome, giant cell arteritis, Fabry disease.The purpose of the research the evaluation and analysis of clinical-demographic characteristics in patients with stroke in the posterior circulation within an institutional cohort. Materials and methods: A retrospective cohort study was performed. The medical records of patients hospitalized with the diagnosis of ischemic stroke (codes I64, I633) from the electronic institutional data register of the Institute of Neurology and Neurosurgery from October 2017 to February 2022 were analyzed and 367 patients were selected. Results: Average age 66.8±10.6 years, men - 62%, women - 38%, average duration of hospitalization 10.3±5.0 bed days. Of all the patients included in the study, 71.4% were diagnosed with primary stroke and 28.6% recurrent. The identified risk factors were arterial hypertension - 96.4%, DM - 35.4%, heart rhythm disorders - 34.1%, coronary ischemic disease - 27.8%, atherosclerosis of the major vessels - 59.9%, dyslipidemia - 27.2%, obesity - 18.5%, anamnestic cerebrovascular events 24.5%, smoking 6.5%. Comorbidities were infection 10.6%, cancer 3.3%, rheumatism 1.6%. Doppler of the extracranial and intracranial vessels detected stenotic atherosclerosis of the main vessels 60.5%, occlusion 4.4%, hypoplasia of the vertebral artery 13.1%. Brain imaging: ischemia 77.4%, leukoaraiosis 55%, atheromatous plaques at the level of carotid siphons 34.6%, cerebral atrophy 19.9%, old stroke 17.4% cases. Conclusions: This study describes the spectrum of risk factors, clinical and demographic characteristics of patients with ischemic stroke in the posterior circulation drawn from the institutional cohort.
References
Frid P, Drake M, Giese A K, Wasselius J, Schirmer MD, Donahue K L, et al. Detailed phenotyping of posterior vs. anterior circulation ischemic stroke: a multi-center MRI study behalf of the Stroke Genetics Network (SiGN), the International Stroke Genetics Consortium (ISGC), and the MRI-Genetics Interface Exploration (MRI-GENIE) Study. 2020;267:649–58.
Sommer P, Posekany A, Serles W, Marko M, Scharer S, Fertl E, et al. Is Functional Outcome Different in Posterior and Anterior Circulation Stroke? Stroke. 2018 Nov;49(11):2728–32.
Posterior circulation ischaemic stroke Áine Merwick stroke and metabolic medicine clinical fellow.
Gurley KL, Edlow JA. SYSTEMATIC REVIEWS (WITH OR WITHOUT META-ANALYSES) Avoiding Misdiagnosis in Patients With Posterior Circulation Ischemia: A Narrative Review. Acad Emerg Med. 2019;26:1273–84.
Nouh A, Remke J, Ruland S, Burns JD, Chang I. Ischemic posterior circulation stroke: a review of anatomy, clinical presentations, diagnosis, and current management. 2014;
Kayan Y, Meyers PM, Prestigiacomo CJ, Kan P, Fraser JF. Current endovascular strategies for posterior circulation large vessel occlusion stroke: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee. J Neurointerv Surg. 2019 Oct;11(10):1055–62.
Alemseged F, Rocco A, Arba F, Schwabova JP, Wu T, Cavicchia L, et al. Posterior National Institutes of Health Stroke Scale Improves Prognostic Accuracy in Posterior Circulation Stroke. Stroke. 2022 Apr;53(4):1247–55.
Republicii MoldovaAL. MINISTERUL SĂNĂTĂŢII, MUNCII ȘI PROTECȚIEI SOCIALE Accidentul vascular cerebral ischemic Protocol clinic național PCN-13.
Mehndiratta M, Pandey S, Nayak R, Alam A. Posterior Circulation Ischemic Stroke-Clinical Characteristics, Risk Factors, and Subtypes in a North Indian Population: A Prospective Study.
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