Journal Article

DZNE-2020-07950

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Detailed phenotyping of posterior vs. anterior circulation ischemic stroke: a multi-center MRI study.

Frid, P. (Corresponding author) ; Drake, M. ; Giese, A. K. ; Wasselius, J. ; Schirmer, M. D.DZNE* ; Donahue, K. L. ; Cloonan, L. ; Irie, R. ; Bouts, M. J. R. J. ; McIntosh, E. C. ; Mocking, S. J. T. ; Dalca, A. V. ; Sridharan, R. ; Xu, H. ; Giralt-Steinhauer, E. ; Holmegaard, L. ; Jood, K. ; Roquer, J. ; Cole, J. W. ; McArdle, P. F. ; Broderick, J. P. ; Jimenez-Conde, J. ; Jern, C. ; Kissela, B. M. ; Kleindorfer, D. O. ; Lemmens, R. ; Meschia, J. F. ; Rundek, T. ; Sacco, R. L. ; Schmidt, R. ; Sharma, P. ; Slowik, A. ; Thijs, V. ; Woo, D. ; Worrall, B. B. ; Kittner, S. J. ; Mitchell, B. D. ; Petersson, J. ; Rosand, J. ; Golland, P. ; Wu, O. ; Rost, N. S. ; Lindgren, A. ; Network, S. G.

2019
Springer77118 Berlin

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Please use a persistent id in citations: doi:10.1007/s00415-019-09613-5

Abstract: Posterior circulation ischemic stroke (PCiS) constitutes 20–30% of ischemic stroke cases. Detailed information about differences between PCiS and anterior circulation ischemic stroke (ACiS) remains scarce. Such information might guide clinical decision making and prevention strategies. We studied risk factors and ischemic stroke subtypes in PCiS vs. ACiS and lesion location on magnetic resonance imaging (MRI) in PCiS.MethodsOut of 3,301 MRIs from 12 sites in the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Genetics Network (SiGN), we included 2,381 cases with acute DWI lesions. The definition of ACiS or PCiS was based on lesion location. We compared the groups using Chi-squared and logistic regression.ResultsPCiS occurred in 718 (30%) patients and ACiS in 1663 (70%). Diabetes and male sex were more common in PCiS vs. ACiS (diabetes 27% vs. 23%, p < 0.05; male sex 68% vs. 58%, p < 0.001). Both were independently associated with PCiS (diabetes, OR = 1.29; 95% CI 1.04–1.61; male sex, OR = 1.46; 95% CI 1.21–1.78). ACiS more commonly had large artery atherosclerosis (25% vs. 20%, p < 0.01) and cardioembolic mechanisms (17% vs. 11%, p < 0.001) compared to PCiS. Small artery occlusion was more common in PCiS vs. ACiS (20% vs. 14%, p < 0.001). Small artery occlusion accounted for 47% of solitary brainstem infarctions.ConclusionIschemic stroke subtypes differ between the two phenotypes. Diabetes and male sex have a stronger association with PCiS than ACiS. Definitive MRI-based PCiS diagnosis aids etiological investigation and contributes additional insights into specific risk factors and mechanisms of injury in PCiS.

Keyword(s): Aged (MeSH) ; Arterial Occlusive Diseases: complications (MeSH) ; Basilar Artery: pathology (MeSH) ; Cerebral Arterial Diseases: complications (MeSH) ; Female (MeSH) ; Humans (MeSH) ; Magnetic Resonance Imaging (MeSH) ; Male (MeSH) ; Middle Aged (MeSH) ; Neuroimaging (MeSH) ; Phenotype (MeSH) ; Stroke: diagnostic imaging (MeSH) ; Stroke: etiology (MeSH) ; Stroke: pathology (MeSH) ; Vertebral Artery: pathology (MeSH) ; Vertebrobasilar Insufficiency: complications (MeSH)

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Contributing Institute(s):

1. Population Health Sciences (AG Breteler)

Research Program(s):

1. 345 - Population Studies and Genetics (POF3-345) (POF3-345)

Appears in the scientific report 2019

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Database coverage:
; ; ; BIOSIS Previews ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; Ebsco Academic Search ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Web of Science Core Collection

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