Long-term outcome in posterior cerebral artery stroke

Area of Science:

• Neurology
• Cerebrovascular Diseases
• Stroke Epidemiology

Background:

• Limited data exists on the long-term prognosis of posterior cerebral artery (PCA) strokes.
• Previous research primarily focused on the topography and pathophysiology of PCA strokes.

Purpose of the Study:

• To investigate the long-term prognosis of PCA strokes.
• To determine the association between infarct localization and long-term outcomes in PCA stroke patients.

Main Methods:

• Analysis of consecutive PCA strokes from the Athens Stroke Outcome Project (1998-2009).
• Classification of strokes into pure PCA infarcts (Groups A & B) and PCA-plus strokes (Groups C & D) based on infarct location.
• Prospective follow-up of patients for up to 10 years.

Main Results:

• PCA-plus strokes showed higher rates of infections and brain edema with mass effect.
• At 6 months, pure PCA infarcts (cortical-only) had better functional outcomes (56% no/minor disability) compared to other groups.
• The 10-year mortality probability was significantly higher for PCA-plus strokes (72.5%) versus pure PCA strokes (55.1%).

Conclusions:

• Pure PCA strokes are associated with a significantly lower risk of disability and long-term mortality.
• PCA strokes with coincident infarcts outside the PCA territory (PCA-plus) indicate a poorer prognosis.