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Published on: August 11, 2023
[The 6-month outcome in patients with vertebrobasilar system cerebral infarction]
Yi Ju1, Yong-jun Wang, Xing-quan Zhao
1Department of Neurology, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China. juyi1126@yahoo.com.cn
Insights
Vertebrobasilar stroke outcomes depend on lesion location and type. Acute basilar artery occlusion and extracranial vertebral artery lesions significantly increase the risk of poor 6-month outcomes in patients with vertebrobasilar system cerebral infarction.
Area of Science:
- Neurology
- Vascular Neurology
- Cerebrovascular Disease
Context:
- Vertebrobasilar system cerebral infarction presents diverse clinical scenarios.
- Understanding factors influencing patient outcomes is crucial for effective management.
- Previous studies have highlighted the complexity of vertebrobasilar occlusive disease.
Purpose:
- To assess the 6-month prognosis for patients experiencing vertebrobasilar system cerebral infarction.
- To identify correlations between specific stroke localizations, vascular lesions, and poor functional outcomes.
Summary:
- A study of 168 patients with vertebrobasilar system cerebral infarction revealed a 19.6% incidence of poor 6-month outcomes.
- Factors associated with poor outcomes included proximal, middle, and distal territory involvement, multiple intracranial territory involvement, acute basilar artery occlusion, and extracranial vertebral artery lesions.
- Mortality was 11.9% and major disability 7.7% at 6 months.
Impact:
- This research provides critical insights into prognostic indicators for vertebrobasilar strokes.
- Findings can guide clinical decision-making and resource allocation for stroke patients.
- Highlights the need for targeted interventions based on specific vascular pathologies and stroke locations.
Objective:
To evaluate the 6-month outcome in patients with vertebrobasilar system cerebral infarction and discuss the correlation of different stroke localization and vascular lesions with poor outcome.
Methods:
168 patients with vertebrobasilar system cerebral infarction, who were admitted in 2003 were evaluated for neurologic impairment and functional handicap. The stroke localization and vascular lesions were evaluated systematically and multivariate logistic regression analysis of the 6-month outcome and correlative factors was performed.
Results:
It was found that the incidence of poor 6-month outcome was 19.6%. The mortality rate was 11.9% and major disability 7.7%. Patients with proximal, middle and distal territory involvement (RR=5.392, 95% CI 1.229-23.657, P<0.05), multiple vertebrobasilar intracranial territory involvement (RR=3.077, 95% CI 0.993-9.537, P<0.05), acute occlusion of basilar artery (RR=11.766, 95% CI 3.455-40.074, P<0.001), extracranial vertebral artery lesion (RR=4.376, 95% CI 1.081-17.714, P<0.05) were more likely to have poor outcome.
Conclusions:
It is shown that vertebrobasilar occlusive disease may consist of a variety of different stroke localizations and vascular lesions, many with of the patients have good prognosis.
