Outcome at 30 days in the New England Medical Center Posterior Circulation Registry.
BACKGROUND
Vertebrobasilar disease is generally considered a condition with a poor prognosis because of high rates of mortality and severe disability.


OBJECTIVE
To compare the outcomes of 407 patients entered in the New England Medical Center Posterior Circulation Registry with the reported results of other studies.


RESULTS
In contrast, among 407 patients prospectively and consecutively studied in the New England Medical Center Posterior Circulation Registry, we found a low mortality rate at 30 days after onset (3.6%) and relatively low rates of major disability (18% using a Modified Rankin Disability Scale score). Thirty days after stroke, 28% of the patients had no disability and 51% had only a minor disability. Stroke location, stroke mechanism, and arteries involved predicted outcome. Basilar artery involvement, embolic stroke mechanism, and multiple posterior circulation intracranial territory involvement correlated with poor outcome. Patients with lesions in the basilar artery were 5 times more likely to have a poor outcome independent of other factors. Lesions in the middle and distal territories were each associated with a poor outcome in one third of the patients.


CONCLUSIONS
In contrast with previous reports, we found that vertebrobasilar occlusive disease consists of a variety of different stroke mechanisms and vascular lesions, many with a good prognosis.
Glass
Thomas A
TA
Division of Cerebrovascular Disease, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215.
Hennessey
Patricia M
PM
Pazdera
Ladislav
L
Chang
Hui-Meng
HM
Wityk
Robert J
RJ
Dewitt
L Dana
LD
Pessin
Michael S
MS
Caplan
Louis R
LR
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000401:mortality* / Q000503:physiopathology*; D001488:Basilar Artery; D004185:Disability Evaluation; D004617:Embolism / Q000150:complications; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D020521:Stroke / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D013997:Time Factors; D014711:Vertebral Artery