Evidence map›Paper›PMID 39238707›Full record

ArticleCureus2024

Etiologies and Risk Factors of Anterior and Posterior Circulation Strokes: A Comparison Study From South India.

Jeffrin John Varghese, Reji Thomas, S Vijayalekshmi, Sheetal Sasikumar, Jeethu T J, Jisa Merin J N

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Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Jeffrin John VargheseNeurology, Pushpagiri Institute of Medical Sciences & Research Centre, Thiruvalla, IND.
Reji ThomasNeurology, Pushpagiri Institute of Medical Sciences & Research Centre, Thiruvalla, IND.
S VijayalekshmiNeurology, Pushpagiri Institute of Medical Sciences & Research Centre, Thiruvalla, IND.
Sheetal SasikumarNeurology, Tiruvalla Medical Mission Hospital, Thiruvalla, IND.
Jeethu T JNeurology, Pushpagiri Institute of Medical Sciences & Research Centre, Thiruvalla, IND.
Jisa Merin J NNeurology, Pushpagiri Institute of Medical Sciences & Research Centre, Thiruvalla, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWhile anterior and posterior circulation strokes share most pathophysiological mechanisms, there is concern that significant differences may exist in some etiopathogenic factors. This study aims to compare the etiologies and risk factors of patients with anterior and posterior circulation strokes to ascertain if the operating mechanisms are any different and warrant different interventions.

methodsA retrospective study compared the etiologies, risk factors, and stroke severity of 350 patients diagnosed with either anterior circulation infarcts (ACI) or posterior circulation infarcts (PCI) confirmed by magnetic resonance imaging. Stroke etiologies were classified according to the Trial of Organization 10172 in Acute Stroke Treatment (TOAST) criteria.

resultsThe sample included 254 patients (72.6%) with ACI and 96 patients (27.4%) with PCI. Patients with PCI had a lower mean NIHSS score on admission (6.05 versus 8.70, p<0.001) and a lower mRS score at discharge (1.91 versus 2.48, p=0.004). The most frequent etiology for both types of strokes was large-artery occlusion, occurring in 77.1% of patients with PCI and 61.4% of those with ACI. PCI patients showed a significantly higher proportion of diabetes mellitus (80.2% versus 68.1%, p=0.025) and hypertension (82.2% versus 67.3%, p=0.006) as compared to patients with ACI. Other risk factors and etiologies were similar across both ACI and PCI.  Conclusions: Our study of South Indian patients showed that the most critical etiology for ACI and PCI was large artery atherosclerosis (LAA), which was relatively more frequent in patients with PCI. Patients with ACI have more severe strokes compared to PCI. Hypertension and diabetes were the more commonly encountered risk factors for PCI than for ACI. Our results imply that mechanisms of stroke for patients with both ACI and PCI are mostly similar, and treatment should address this correlation rather than focus on other differences. Stricter control of diabetes and hypertension may be warranted for patients with PCI, considering the more significant role attributed to these risk factors in this stroke category.

Indexed as

anterior circulation infarctionetiologyposterior circulation infarctionrisk factorsstroke

Identifiers

PMID39238707
PMCPMC11375124

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