| ObjectiveBased on the clinical data of86patients with posterior circulation cerebralinfarction, which were retrospectively analyzed, to understand the clinicalcharacteristics, pathological changes, risk factors of posterior circulation cerebralinfarction and their influence on prognosis, so as to the clinical diagnosis andtreatment of patients with posterior circulation cerebral infarction and prognosisevaluation to provide certain reference basis.Materials and MethodsCollect the second affiliated hospital of zhengzhou university neurology, fromJune2011to October2013in hospital during the period of364patients with acutecerebral infarction were screened up to the standard of diagnosis of posteriorcirculation cerebral infarction patients86cases, detailed records of all patients’demographic characteristics, risk factors, clinical manifestations, imagingcharacteristics and blood biochemical examination results etc, in order to facilitatedescribe the infarction area, according to head CT or MRI/DWI is shown in thelesion site, and posterior circulation blood vessels used in reference to NEMC-PCRdominate distinguish standard, pathological changes of patients with posteriorcirculation ischemia can be divided into four areas: the proximal, middle,distal andmixed group, the clinical and imaging characteristics of carbonates;Comparing withcirculating cerebral infarction patients prior to the selection in the same period, analyzing the characteristics of the posterior circulation cerebral infarction riskfactors;Then according to the modified Rankin disability scale (mRS) criteria, allpatients were divided into good prognosis group and poor prognosis group.Firstusing chi-square or t test on two groups of the prognosis of patients with singlefactor comparison, and then using multiariable Logistic regression analysis thefactors,which has been confirmed by single factor comparison has significantinfluence on prognosis.Results1.86cases confirmed by head CT or MRI for the patients with posteriorcirculation cerebral infarction, the most common lesions located in the middle group,there are33cases accounted for38.4%of the total patients, followed by distal groupof26cases (30.2%),mixed group of16cases (18.6%),and the last is proximal groupof11cases (12.8%).2.The most common site of onset in the pons in23cases (26.7%), followed bythe cerebellum in12cases (14.0%), medullary9cases (10.5%), occipital8cases(10.3%), thalamus6cases (7.0%), in brain5(5.8%), temporal lobe4cases (4.7%).3. Clinical manifestations of86cases of posterior circulation cerebral infarctionof the most common clinical symptoms were53cases (61.63%), limb weakness,dysarthria in49cases (56.98%), dizziness,47cases of35cases (54.65%), nauseaand vomiting (40.70%);The most common clinical signs are feeling obstacle37cases (43.02%), ataxia,33eyes (38.37%),25cases (29.07%), eye closure is difficultto set up23cases (26.74%).Single signs or symptoms of relatively rare, but most ofthe patients with the combination of several symptoms or signs.4.Cross damage and the typical clinical syndrome is less common,cross-sensory impairments which9cases (10.47%), cross dyskinesia10cases(11.63%);Proximal group have Wallenberg syndrome,3patients (3.5%); middlegroup of Locked-in syndrome seen in2cases (2.3%), the Raymond-Cestansyndrome and One and a half syndrome in1case (1.2%); distal group of Top of thebasilar artery syndrome3cases (3.5%).5.Common risk factors in the posterior circulation cerebral infarction withhypertension is the most common accounting for72.1%of the total, followed by: hyperlipidemia (54.7%), diabetes (51.2%), smoking history (45.3%), stroke history(33.7%), heart disease (25.6%), alcohol abuse (18.6%). Compared with the twogroups,posterior circulation group hyperlipidemia and diabetes more common,(p<0.05) were statistically significant. Posterior circulation group with a single riskfactor for the onset of infarction is rare only10cases (11.63%), while the majority ofpatients with2-4risk factors; two groups compared with the number of risk factors(p>0.05) no significant difference.6.Effectively at all86patients, the prognosis of53cases (61.63%), severedisability in29(33.72%),4cases died (4.65%).7.Univariate analysis significantly poor prognosis group of patients with anaverage age of larger, higher admission NIHSS score, hyperlipidemia, highhomocysteine and concurrent respiratory infections are more common p value <0.05was considered statistically significant. Site in the two groups in the incidence of p=0.004(<0.05), the difference was statistically significant.8.Multiariable Logistic regression analysis found that the NIHSS score onadmission, homocysteine hematic disease, infection of the respiratory systemcomplications and mixed group of lesions associated with prognosis.Conclusion1.The most common diseased parts of posterior circulation ischemic stroke inthe middle,especially in the pons most frequent.2.Posterior circulation cerebral infarction of the complex and varied clinicalmanifestations, according to a localization diagnostic significance of cross typedamage and typical clinical syndrome incidence is low.3.Risk factors are the influence factors of posterior circulation cerebralinfarction occurred, but not the determinant of prognosis.Hypertension is the mostcommon risk factors, but with only a single factor is a rare disease, mostly with twoto four factors,Similar to the anterior circulation infarction.4.The NIHSS score higher on admission, homocysteine hematic disease,infarction with respiratory system infection and multiple lesions is a poor prognosis. |
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