Clinical presentation as a guide to early prognosis in vertebrobasilar stroke.
OBJECTIVE
This study attempts to assess the feasibility and heuristic value of a classification scheme for vertebrobasilar stroke.


METHODS
Fifty-seven consecutive patients with vertebrobasilar stroke were classified on the basis of clinical features and computed tomographic abnormalities into single-sector (n = 19), multisector (n = 11), and top-of-the-basilar (n = 27) groups; a sector was defined as that portion of the brain stem supplied by a single penetrating (median) or branch (paramedian or lateral) artery.


RESULTS
Thirty-day and 3-year survival rates were 100% and 71%, respectively, in the single-sector group, and 96% and 73%, respectively, in the top-of-the-basilar group. Thirty-day and 3-year stroke recurrence free survival rates were 89% and 76%, respectively, in the single-sector group, and 96% and 88%, respectively, in the top-of-the-basilar group. Seven of the 11 patients in the multisector group died within 2 months of ictus, three having experienced recurrence.


CONCLUSIONS
These data, in part supported by prior studies, demonstrate the feasibility and heuristic value of the classification scheme and suggest that single-sector and top-of-the-basilar stroke patients have a relatively benign early prognosis and modest long-term stroke rates.
Nadeau
S
S
Geriatric Research, Education and Clinical Center, Veterans Affairs Medical Center, Gainesville, FL 32608-1197.
Jordan
J
J
Mishra
S
S
D000206:Actuarial Analysis; D001488:Basilar Artery; D002561:Cerebrovascular Disorders / Q000145:classification* / Q000401:mortality; D006801:Humans; D002546:Ischemic Attack, Transient / Q000145:classification; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis; D013997:Time Factors; D014711:Vertebral Artery