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KMID : 1130620050010010014
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Journal of Clinical Neurology
2005 Volume.1 No. 1 p.14 ~ p.30
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New England Medical Center Posterior Circulation Stroke Registry: Ⅰ. Methods, Data Base, Distribution of Brain Lesions, Stroke Mechanisms, and Outcomes
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Caplan LR
Chung CS
Wityk RJ
Glass TA
Tapia J
Pazdera L
Chang HM
Dashe JF
Chaves CJ
Vemmos K
Leary M
Dewitt LD
Pessin MS
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Abstract
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Among 407 New England Medical Center Posterior Circulation Registry (NEMC-PCR) patients, 59% had strokes without transient ischemic attacks (TIAs), 24% had TIAs before strokes, and 16% had only posterior circulation TIAs. Embolism was the commonest stroke mechanism accounting for 40% of cases (24% cardiac origin, 14% arterial origin, 2% had potential cardiac and arterial sources). In 32%, large artery occlusive lesions caused hemodynamic brain infarction. Stroke mechanisms in the posterior and anterior circulation are very similar. Infarcts most often included the distal posterior circulation territory (rostral brainstem, superior cerebellum and occipital and temporal lobes), while the proximal (medulla and posterior inferior cerebellum) and middle (pons and anterior inferior cerebellum) territories were equally involved. Infarcts that included the distal territory were twice as common as those that included the proximal or middle territories. Most distal territory infarcts were attributable to embolism. Thirty day mortality was low (3.6%). Embolic stroke mechanism, distal territory location, and basilar artery occlusive disease conveyed the worst prognosis
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KEYWORD
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Brain ischemia, Brain embolism, Posterior circulation, Vertebral arteries, Basilar artery
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