Basilar artery occlusive disease in stroke survivors in a multiethnic population.
OBJECTIVE
To describe clinical, radiological findings, and outcome in a multiethnic population of stroke survivors with basilar artery occlusive disease (BAOC).


METHODS
Forty patients with infarcts in the basilar artery (BA) territory, alive 30 days after the ictus, participated in the study. BA stenosis (>50%) or occlusion was shown by magnetic resonance or digital subtraction angiography in all patients. Demographical, clinical and radiological characteristics were described. Modified Rankin Scale (MRS) scores at 30 days and 6 months after the ischemic event were evaluated. Association between demographical, clinical, radiological features and outcome were analyzed with Chi-square and Fisher's exact tests. MRS scores at 30 days and 6 months were compared with the Wilcoxon test.


RESULTS
Sixty percent of the patients were men, and 33% were Afro-Brazilian. Mean age was 55.8+/-12.9 years. Most (90%) had multiple vascular risk factors. Stroke was preceded by TIA in 48% of the patients, and 80% had a history of arterial hypertension. The most common neurological symptom was vertigo/dizziness (60%) and the sign, hemiparesis (60%). Most of the infarcts were located in the pons (85%) and the BA middle third was the most frequently affected segment (33%). BA occlusion occurred in 58% of the patients. More severe vascular occlusive lesions were present in Whites (p=0.002) and in patients with involvement of the middle third of the BA (p=0.021). Large-artery atherosclerosis was the most common stroke etiology (88%) and was more frequent in older patients (p<0.001). Most patients were treated with anticoagulation. MRS scores improved significantly at 6 months (p<0.001); at this time, 78% of the patients had MRS scores between 0 and 2.


CONCLUSIONS
We observed different results compared with other series: greater proportion of Afro-descendents, higher frequency of atherosclerosis and BA occlusion. Rates of preceding TIAs and good outcome at 6 months were similar to previously published data. These results represent a step forward towards understanding BAOC in a multiethnic context.
Ciríaco
Jovana Gobbi Marchesi
JG
Neurology Department, Hospital das Clínicas, São Paulo University, São Paulo, Brazil.
Leite
Claudia da Costa
Cda C
dMartin
Maria a Graça Morais
Ma
Barros
Cristiano Venturim
CV
Puglia
Paulo
P
Caldas
José Guilherme Pereira
JG
Scaff
Milberto
M
Conforto
Adriana Bastos
AB
D000328:Adult; D000367:Age Factors; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D044383:Black People / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D002533:Cerebral Angiography; D004244:Dizziness / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D002546:Ischemic Attack, Transient / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017741:Survivors / Q000706:statistics & numerical data*; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000208:ethnology; D014717:Vertigo / Q000209:etiology