Clinical Analysis Of Acute Cerebral Infarction Of Posterior Circulation

ObjectiveTo explor the cause, risk factors, predilection, TOAST classification,cerebrovascular imaging characteristics about acute cerebral infarction of posteriorcirculation. To understand the clinical characteristic of acute cerebral infarction ofposterior circulation,and to study the pathogenesis of stroke. Provide the basis forcondition assessment,secondary prevention and treatment, So as to reduce theincidence and morbidity of stroke.MethodsTo choose180patients with acute cerebral infarction in jiaozuo coal groupcentral hospital neurology department from January2011to January2012. They weredivided into two groups，There are56cases of male and24cases of female in80patients with acute cerebral infarction of posterior circulation in one group. Theywere aged between40to78and the average age of68.5±10.5years old. There are70cases of male and30cases of female in100patients of acute cerebral infarction ofanterior circulation in another group. They were aged between45to75and and theaverage age of65.3±11.1years old. Two groups of patients were retrospectivelyanalysised on risk factors, predilection, TOAST classification and cerebral imagingcharacteristics. All the data were analysised by SPSS13.0statistical software. Results1Risk factorsAge, hypertension, diabetes, heart disease, hyperlipidemia, smoking and historyof previous stroke are high risk factors of the acute cerebral infarction of posteriorcirculation and anterior circulation. Comparing the two groups, there were nostatistically significant difference. But vertebral-basilar artery morphologicalchange was statistically difference.2TOAST classificationIn the patients with acute cerebral infarction of posterior circulation, Smallartery occlusion type(SAA) is the most common (51.25%), followed by large-arteryatherosclerosis(LAA)(31.25%). In the patients with the acute cerebral infarction ofanterior circulation, large-artery atherosclerosis (LAA) is the most common type(47%), followed by small artery occlusion type (LAA)(32%), Compared the twogroups, P <0.05, the difference was statistically significant. Compared with cardioembolism,other determined etiology and undetermined etiology between the twogroups，P>0.05, there were no statistically significant difference.3Infarction areaIn the patients with acute cerebral infarction,of posterior circulation, distalinfarction accounted for50%, middle infarction accounted for27.5%,proximal infarction accounted for22.5%. Distal infarction is the most common. Inthe patients with acute cerebral infarction,of posterior circulation, the single lesionsare the largest number, it accounted for61.25%.The multiple lesions accounted for38.75%. In the patients with acute cerebral infarction of anterior circulation, theSingle lesions accounted for45%,the Multiple lesions accounted for55%. Comparedto two groups, P=0.03, the difference was statistically significant.4Clinical symptomsClinical signs of acute circulation cerebral of posterior circulation were followedby dysarthria, dyskinesia,of unilateral limb, bucking, sensory disorder of unilaterallimb, central facial paralysis, ataxia, nystagmus, diplopia, ocular motility disorders,bilateral limbs dyskinesia, contralateral sensory disturbance, disturbance ofconsciousness, the pathological character. And the incidence of bucking, ataxia, ocular motility disorders, dizziness and nystagmus in the group of acute circulationcerebral of posterior circulation were significantly more than acute circulationcerebral of anterior circulation. Compared to two groups, the difference wasstatistically significant.5Vascular imaging characteristicsThe vascular imaging characteristics of acute circulation cerebral of posteriorcirculation are basilar artery and its branches stenosis,intracranial and extracranialsegments’s vertebral artery stenosis or occlusion and vertebral artery advantage.6The prognosisIt is similar to the prognosis of acute cerebral infarction of posterior circulationand anterior circulation. Compared to two groups, there were no statisticallysignificant difference..conclusion1The risk factors of acute cerebral infarction of posterior circulation is agehypertension, diabetes, heart disease, hyperlipidemia, smoking and history of stroke.2In the patients with acute cerebral infarction of posterior circulation, smallartery occlusion type(SAA) is the most common type and followed by large-arteryatherosclerosis(LAA).3Distal infarction is the most common of acute cerebral infarction of posteriorcirculation, followed by middle infarction and proximal infarction. The single lesionsare the largest number.4The more common clinical signs of acute cerebral infarction of posteriorcirculation are bucking, ataxia, ocular motility disorder, dizziness, nystagmus.5The more common type of vascular lesions of acute cerebral infarction ofposterior circulation are vertebral artery advantage and vertebral-basilar arterystenosis or occlusion.6It is similar to the prognosis of acute cerebral infarction of posterior circulationand anterior circulation.