Related Experiment Video
Updated: Jun 12, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
14.7K
Outcome Predictor Differences in Infratentorial and Supratentorial Ischemic Stroke
Manuel Bolognese1, Mareike Österreich1, Martin Müller1
1Department of Neurology and Neurorehabilitation, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland.
Life (Basel, Switzerland)
|April 26, 2025
Summary
Outcome-relevant factors (ORFs) for acute ischemic stroke differ by location. Infratentorial strokes are linked to atrial fibrillation and kidney function, while supratentorial strokes are primarily influenced by neurological deficit and age.
Area of Science:
- Neurology
- Stroke Medicine
- Vascular Neurology
Background:
- Acute ischemic stroke outcomes are multifactorial.
- Understanding outcome-relevant factors (ORFs) is crucial for patient management.
- Vascular territory and therapeutic strategies may influence these ORFs.
Purpose of the Study:
- To investigate differences in ORF profiles between infratentorial and supratentorial stroke vascular territories.
- To explore how ORF profiles vary with different therapeutic strategies in acute ischemic stroke.
Main Methods:
- Retrospective analysis of 410 comprehensive stroke center patients.
- Classification of outcomes using the modified Rankin Scale (mRS) at three months (good ≤2, poor >2).
- Comparison of infratentorial vs. supratentorial stroke groups using Kruskal-Wallis or chi-squared tests, followed by univariate and multinomial logistic regression.
Main Results:
- Infratentorial strokes showed less severe initial neurological deficit and lower rates of cardiac risk factors but higher rates of large vessel disease compared to supratentorial strokes.
- For infratentorial strokes, poor outcomes were associated with atrial fibrillation (OR 13.73), estimated glomerular filtration rate (OR 0.96), and diabetes mellitus (OR 7.69).
- For supratentorial strokes, poor outcomes were predominantly associated with the National Institute of Health Stroke Scale (NIHSS) score (OR 1.32) and age (OR 1.04 in the overall supratentorial group).
Conclusions:
- Outcome-relevant factors for acute ischemic stroke significantly differ between infratentorial and supratentorial vascular territories.
- Atrial fibrillation, estimated glomerular filtration rate, and diabetes mellitus are key predictors of poor outcomes in infratentorial strokes.
- Neurological deficit severity (NIHSS) and age are the primary predictors of poor outcomes in supratentorial strokes.
Related Concept Videos
01:29Stroke: Introduction and Types
A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:26Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...