Posterior Circulation Ischaemic Stroke

Area of Science:

• Neurology
• Vascular Medicine

Background:

• Posterior circulation ischaemic stroke (PCIS) accounts for 20-25% of all ischaemic strokes.
• PCIS is associated with high mortality, morbidity, and worse functional outcomes compared to other stroke types.
• Symptoms include vertigo, visual disturbances, and sensory/motor deficits.

Purpose of the Study:

• To review the current understanding of PCIS, including its causes, risk factors, diagnosis, and management.
• To highlight the need for increased clinical attention and research in PCIS.
• To identify areas for future research in PCIS.

Main Methods:

• Review of existing literature on PCIS.
• Analysis of common causes, risk factors, and diagnostic techniques.
• Evaluation of current treatment strategies and outcomes.

Main Results:

• Key causes include large artery atherosclerosis, embolism, and vertebrobasilar dolichoectasia.
• Hypertension is the most common risk factor; diabetes mellitus is more specific to PCIS.
• Neuroimaging techniques are crucial for diagnosis, assessing brain structure, vascular patency, and perfusion.

Conclusions:

• PCIS requires comprehensive management including medical treatment, lifestyle modifications (smoking cessation, weight control, diet), and aspirin use.
• Intravascular and intra-arterial thrombolysis show promise, but evidence for stenting/angioplasty is inconclusive.
• Future research should focus on epidemiology, anatomical variants, and collateralization.