Khorasan Posterior Circulation Stroke Registry: a Hospital-Based Study

Background: clinical information about stroke in the vertebrobasilarterritory has lagged behind that for anterior circulationsyndrome. this is the first report from posterior circulationsyndrome registry in iran.methods: consecutive patients with brain infarction in vertebrobasilarterritory admitted to ghaem hospital, mashhadwere enrolled in a prospective study during 2006-2007. diagnosisof ischemic stroke in the posterior circulation was madeby a stroke neurologist based on the clinical manifestationsand neuroimaging. vertebrobasilar territory infarcts were classifiedinto five groups according to the location involved:brainstem, thalamus, cerebellum, posterior cerebral artery, andmixed categories. all of the stroke patients underwent a standardbattery of diagnostic investigations and the etiology ofischemic stroke was determined by the practical iranian criteriaclassification. the 72-hour stroke course determined asregressive, stable, and deteriorative.results: total of 302 patients (147 females, 155 males) withmean age 62.5 years (±17.2) were investigated. posterior cerebralartery, thalamus, brain stem, cerebellum, and mixed categoriesconsisted 31.3%, 4.3%, 32.8%, 17.9%, and 13.9% ofthe stroke topographies respectively. atherosclerosis consisted50.6% of etiologies in our patients followed by uncertain(25.5%), cardioembolism (12.5%), both atherosclerosis andcardioembolism (6.3%), and miscellaneous causes (4.6%).rheumatic mitral stenosis was the cause in 34.2% of our patientswith cardiac emboly. the distribution of stroke etiologiesbased on its localization was not significantly different(df=16, and p=0.421). stable status was the most commonearly stroke course (57.7%) followed by deteriorative (22.1%),and regressive (20.2%). a significant association betweenstroke localization in the vertebrobasilar territory and itscourse was not found (df=8, and p=0.901).conclusion: atherosclerosis is the most common cause ofposterior circulation syndrome in iranian patients. the causeof stroke in the posterior circulation could not reliably be derivedfrom infarct topography.