| Background:.Previous study mostly concentrated to anterior circulation, because of the limitation of CT in the documentationof lesions and the etiology in posterior circulation stroke.The advent of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), with their better imaging quality, the stroke mechanism,clinical feature and prognosis factors become the study hot spot .However, existing studies were mostly conducted in western countries.The studies in Asia were retrospective,and the results varies among these studies.Objectives: To observe the stroke mechanism,clinical feature,risk factors, distribution of infarct in posterior circulation stroke,and study the relations to prognosis. In the end,we compare the results with other countries' studies.Materials and method: 1. From July.1, 2002 to. December 1, 2006, the consecutive cases of stroke in the neurological wards of the West China Hospital, Sichuan University were prospectively registered. The patients suffered from posterior circulation stroke were included in the study Sociodemographic characteristics, vascular risk factors,NIHHS marks and other clinical characteristics during hospitalization related to the outcome were collected,and then followed up the outcome at the end of 3rd, 6th and 12th month after the onset of stroke. The outcome was death, disability and stroke recurrence. 2 We confirmed the stroke types by the results of CT, MRI,and other auxiliary examination,and then analyzed the clinical feathers and the risk factors between stroke types. Univariate and multivariate logistic regression were used respectively to analyze t the prognostic value of stroke types to predicting death, disability or recurrence.Results: 1. The total consecutive cases of 349 posterior circulation stroke were included .2 Of all the ischemic stroke patients ,12.6% , 27.8% ,36.4% ,0.6% ,and22.6%were classified as cardioembolicm ,large-artery atherosclerotic , lacunare , of other demonstrated etiology and of undetermined etiology.3 93patients (26.6%) had infarcts in two or more intracranial territories . A total of 256patients (73.3%) had infarct in one vascular territory. Among them,infarct in the middle territory was the most common (128patients, 36.7%),followed by the distal territory (87patients, 24.9%)and the proximal territory (41patients, 11.7%).4The mortality rates are 6.8%,9.5% and 16.3% ,death/disability rate are 33.1%,32.8%,and 29.1% , recurrence rate are 1.4%,3.2%and 4.5% at 3rd month,6th month, and 1st year,respectively.5Complication, NIHSS marks, merging anterior circulation stoke distribution of infarct,are independent predictors of death and death/disability at the end of 3rd month; Complication and GCS marks are independent predictors of death at the end of 6 th month; Complication ,NIHSS marks, merging anterior circulation stoke and stenosis artery are independent predictors of at the end of death/disability 6 th month.6The difference of the mortality rate, death/ disability rate,the masccline rate of high blood pressure, diabetes, atrial fibrilation, valvular disease of the heartbetween stroke types have statistical significance.Conclusion:lThere are 349 posterior circulation stroke patients(17.08%) among the total 2043 ischemic stroke patients .2The most common location of infarcts was in the middle territory.3 Of all the ischemic stroke patients, the most common stroke type is small vessel occlusion ,cardioembolism 12.6%,the same with studies in Asian ,not the same with studies in western countries .4 Hypertension was a prevalent risk factor being noted in 61.9% of patients.5 The difference of the mortality rate, death/ disability rate have statistical significance between stroke types.6 Complication, NIHSS marks, merging anterior circulation stoke distribution of infarct, valvular disease of the heart, Stroke Mechanism are independent predictors。...
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