Posterior circulation ischaemic stroke - A retrospective analysis from a General Hospital

Abstract

: Even though ischemic stroke represents a majority of strokes in general, only a smaller portion originate from posterior circulation. Because of different origin and particular territory involvement, this represents a difficult clinical task. We compared relevant clinical data from literature with results of our patients affected by the posterior circulation stroke (PCS). We analyzed stroke patients admitted from 2018. to 2022. in General Hospital Pula, a touristic oriented county hospital in Croatia on the Adriatic Coast. In that five-year period we admitted 1795 patients with ischemic stroke. 246 or 13,6% of those originated from the posterior circulation, which is significantly less than data from similar reports. Majority of those patients were male, 64%. Comparing the outcome, we found that the PCS had significantly better outcome. Mortality rate was similar in both,14% for PCS versus 16% in the anterior circulation strokes (ACS). We analyzed the outcome by infarct region or etiology, as well as clinical particularities related to the territory of PCS involvement. We also selected patients having PCS as a result of dissection. According to our results the patients with PCS had better outcome in comparison to ACS. The most frequent site of stroke was cerebellar, followed by pontine stroke. The highest mortality was observed in patients with multiple posterior circulation strokes. Initial NIHSS score was lower in posterior circulation strokes then in anterior circulation strokes, with an important impact on reperfusion therapy rates. Therefore, it is crucial to perform comprehensive clinical evaluation of patients with posterior circulation ischemic strokes.