한림 뇌졸중 등록 자료에서 후방 순환계 뇌졸중의 임상양상

Abstract

Department of Neurology, Hallym University College of Medicine Background & Objective: Studies of the subtypes and etiologies of cerebral infarction have been largely limited to the anterior circulation. To better understand clinical patterns, risk factors and subtypes of posterior circulation disease, we analyzed both clinical and imaging data of Hallym Stroke Registry. Methods: We investigated demographic features, risk factors, stroke subtypes, lesion distributions and clinical outcomes of 542 cases (36.5%) of ischemic stroke in posterior circulation enrolled at Hallym Stroke Registry between January 1996 and July 2002, which included totally 1,486 cases with acute ischemic stroke. Stroke subtypes were categorized as large-artery atherosclerosis (LAA), small vessel occlusion SVO), cardioembolism(CE), stroke of other determined etiology(SOE), and stroke of undetermined etiology(SUE). The location of brain lesion was categorized as proximal, middle, and distal intracranial posterior circulation territory. Results: Age and gender of ischemic stroke in posterior circulation were comparable to those of ischemic stroke in anterior circulation. The most frequent stroke subtype in posterior circulation disease was LAA(51.8%), followed by SVO(32.7%), SUE(8.5%), CE 5.0%) and SOE(2.0%). Hypertension was found in 68.8%, smoking in 32.1%, diabetes mellitus in 29.7%, a history of previous stroke in 20.8%, hyperlipidemia in 24.4%, cardioembolic sources in 10.7%, respectively. The most common location of infarcts was in the middle territory (40.0%), followed by distal (28.1%), proximal (20.2%), and multiple territories (11.7%). The outcomes at discharge and in-hospital mortality of posterior circulation disease were similar to those of anterior circulation disease. Conclusion: In Hallym Stroke Registry, posterior circulation disease comprised of 36.5%. The distribution of stroke mechanisms and lesion location of posterior circulation disease were different from those of the western country. The clinical outcome of posterior circulation disease was not worse than that of anterior circulation disease.