Investigation Of Clinical Manifestation And MRI In Patients With Posterior Circulation Ischemia

Objective to study the relative prevalence,clinical manifestation,MRI feature,risk factor,hospital day and mechanism of patients with-posterior circulation ischemia (PCI).Methods 133 patients with PCI in 480 patients of acute ischemia stroke who were admitted in 2007-6 to 2008-6 were selected.The clinical manifestation,MRI feature,risk factor,hospital day and mechanism were evaluated retrospectively. Results It was found that the relative prevalence of PCI was 27.7%.Among 133 patients,with PCI,124 ones were posterior circulation infarction,the other 9 were transient ischemic attack(TIA) of posterior circulation.The clinical manifestations such as hemiplegia(76,61.3%),dysarthria(74,59.7%),vertigo(69,55.6%) were common in patients with posterior circulation infarction.While vertigo(9,100%), ataxia(7,77.8%),nystagmus(6,66.7%)were more frequent in patients with TIA of posterior circulation.The lesions confirmed by MRI were seen in pontine 40.3% (50/124),occipital lobe 29.0%(36/124),thalamus 21.8%(27/124),cerebellum 16.9% (21/124),mesencephalon 7.3%(9/124),oblongata medullary 6.5%(8/124) respectively. Atherosclerosis(102,76.7%),hypertension(99,74.4%),increased LDL(95,71.4%), increased homocysteic acid in blood(95,71.4%) were common risk factors.Embolism was the main cause in 66 patients(53.2%).Embolus from heart in 35 patients,while 31 were from artery.15 patients had conscious disturbance.10 of them had more than one lesion in MRI.Both sides of brain stem were involved in 3 of the 15 patients.2 of them had large lesions in both sides of cerebellum.12 patients of the 15 were caused by cardiac embolism.The other 3 were caused by artherosclerosis.The hospital day of patients with cardiac embolism(23) were longer than those with non-cardiac embolism. There was a significant difference between the two above(P=0.043＜0.05).Conclusions The clinical manifestations in patients with PCI are complicate,but the characteristic presentation is helpful for diagnosis.MRI can be helpful in diagnosis of PCI.Cardiac embolism always imply poor prognosis.