Factors Related To The Initial Stroke Severity Of Posterior Circulation Ischemic Stroke

Objective The aim of our study was to investigate the factors related to the initial stroke severity of Posterior circulation (PC) ischemic stroke and 3-month outcome.Methods Patients group consist of 60 patients with first-time PC ischemic stroke in the first affiliated hospital of Kunming Medical University, department of neurology from 2014 January to 2015 January.60 patients were given a complete evaluation including brain magnetic resonance imaging (MRI) and brain and neck angiographic studies including computerized tomography angiography (CTA) or magnetic resonance angiography (MRA). The neurological deficits of Patients were evaluated by National Institutes of Health Stroke Scale (NIHSS) on the day of admission. Patients were divided into two groups by the baseline NIHSS: moderate-to-severe stroke (MTSS, NIHSS> 5) and mild stroke (MS, NIHSS≤5). Patients’ demographics, comorbidities, initial blood laboratory tests (including white blood cell (WBC) count, glucose levels, high sensitivity C-reactive protein (hs-CRP) levels, erythrocyte sedimentation rate (ESR) and fibrinogen, symptoms, progressive neurological deficits, etiological classification, lesion characteristics from imaging (categorized as involving proximal, middle and distal territories) were comparatively analyzed between the two groups. Patients’3-month outcomes were assessed by the modified Rankin Scale (mRS).Results Among 60 patients with first-time PC ischemic stroke,14 belonged to the MTSS group and 46 to the MS group. Logistic regression analysis of baseline characteristics, symptoms, progressive neurological deficits, etiological classification, lesion characteristics from imaging and prognosis between the two groups show: MTSS was independently associated with dysarthria (OR=24.73, P=0.006), Middle territory (OR=17.61, P=0.002), weakness (Oi?=19.23, P=0.043) and dysphagia (OR=4.31, P=0.031); The independent predictors associated with a 3-month mRS of 3-6 were MTSS (OR=8.23,P=0.003) and dysarthria (OR=7.25, P=0.006).Conclusions The severity categorization of PC ischemic stroke by the baseline NIHSS in clinical work has preliminarily provided two distinctions and could help with the prediction of 3-month clinical outcome.