Clinical Analysis Of Causes Of Misdiagnosed Posterior Circulation Infarcts In The Initial Stage

Objective: To improve the recognition with posterior circulation infarcts and reduce misdiagnosis of posterior circulation infarcts. Methods: From January 2004 to February 2007, in Department of Neurology of People's Hospital of Xinjiang Vygur Autonomous Region 59 cases with acute posterior circulation infarcts, there were18 cases misdiagnosed as the other diseases. Retrospective survey of misdiagnosed diseases, clinical manifestations and accessory examinations was made in the 18 patients. Results: 18cases were misdiagnosed as the other diseases: Vertebrobasilar insufficiency in 11 cases (61.11%); hypertensive encephalopathy in 2 cases(11.11%); meniere disease in 1 case(5.56%);encephalitis in 1 case(5.56%);transient ischemic attach inlcase(5.56%); ophthalmocace in 1 case(5.56%); neurogliocytoma in 1 case(5.56%). Conclusion: There were four causes for misdiagnosis of posterior circulation infarcts: 1.There were more equivocal symptoms in early stage after the onset of stroke.2.Past history interfered with thinking trend of clinicians. 3. Clinicians utilized by mistake imaging technique. 4. Clinicians lacked of recognition for posterior circulation infarcts. 5.Clinicians overdepended on imaging technique. To reduce misdiagnosis, complete and comprehensive analysis should be made on the basis of the age, the past history, careful neurologic physical examination, and image technique. MRI and MRA should be routine measurement for posterior circulation infarcts.