Detailed phenotyping of posterior vs. anterior circulation ischemic stroke: a multi-center MRI study

• DOI: 10.1007/s00415-019-09613-5
• Publication Date: 2019-11-11T04:23:56Z
• Authors: Petrea Frid; Mattias Drake; A. K. Giese; J. Wasselius; M. D. Schirmer; K. L. Donahue; L. Cloonan; R. Irie; M. J. R. J. Bouts; E. C. McIntosh; S. J. T. Mocking; A. V. Dalca; R. Sridharan; H. Xu; E. Giralt-Steinhauer; L. Holmegaard; K. Jood; J. Roquer; J. W. Cole; P. F. McArdle; J. P. Broderick; J. Jimenez-Conde; C. Jern; B. M. Kissela; D. O. Kleindorfer; R. Lemmens; J. F. Meschia; T. Rundek; R. L. Sacco; R. Schmidt; P. Sharma; A. Slowik; V. Thijs; D. Woo; B. B. Worrall; S. J. Kittner; B. D. Mitchell; J. Petersson; J. Rosand; P. Golland; O. Wu; N. S. Rost; A. Lindgren
• Keywords: Neuroradiology; Acis; Stroke

Abstract Objective Posterior circulation ischemic stroke (PCiS) constitutes 20–30% of cases. Detailed information about differences between PCiS and anterior (ACiS) remains scarce. Such might guide clinical decision making prevention strategies. We studied risk factors subtypes in vs. ACiS lesion location on magnetic resonance imaging (MRI) PCiS. Methods Out 3,301 MRIs from 12 sites the National Institute Neurological Disorders Stroke (NINDS) Genetics Network (SiGN), we included 2,381 cases with acute DWI lesions. The definition or was based location. compared groups using Chi-squared logistic regression. Results occurred 718 (30%) patients 1663 (70%). Diabetes male sex were more common (diabetes 27% 23%, p < 0 .05 ; 68% 58%, 0.001). Both independently associated (diabetes, OR = 1.29; 95% CI 1.04–1.61; sex, 1.46; 1.21–1.78). commonly had large artery atherosclerosis (25% 20%, 0.01) cardioembolic mechanisms (17% 11%, 0.001) to Small occlusion (20% 14%, accounted for 47% solitary brainstem infarctions. Conclusion Ischemic differ two phenotypes. have a stronger association than ACiS. Definitive MRI-based diagnosis aids etiological investigation contributes additional insights into specific injury