title: New England medical center posterior circulation stroke registry: I. Methods, data base, distribution of brain lesions, stroke mechanisms, and outcomes.
abstract: Among 407 New England Medical Center Posterior Circulation Registry (NEMC-PCR) patients, 59% had strokes without transient ischemic attacks (TIAs), 24% had TIAs before strokes, and 16% had only posterior circulation TIAs. Embolism was the commonest stroke mechanism accounting for 40% of cases (24% cardiac origin, 14% arterial origin, 2% had potential cardiac and arterial sources). In 32%, large artery occlusive lesions caused hemodynamic brain infarction. Stroke mechanisms in the posterior and anterior circulation are very similar. Infarcts most often included the distal posterior circulation territory (rostral brainstem, superior cerebellum and occipital and temporal lobes), while the proximal (medulla and posterior inferior cerebellum) and middle (pons and anterior inferior cerebellum) territories were equally involved. Infarcts that included the distal territory were twice as common as those that included the proximal or middle territories. Most distal territory infarcts were attributable to embolism. Thirty day mortality was low (3.6%). Embolic stroke mechanism, distal territory location, and basilar artery occlusive disease conveyed the worst prognosis.
authors.affiliation: Cerebrovascular Disease Sections of the New England Medical Center, Boston and the Beth Israel Deaconess Medical Center, Boston.
authors.forename: Lr
authors.initials: L
authors.lastname: Caplan
authors.forename: C-S
authors.initials: CS
authors.lastname: Chung
authors.forename: Rj
authors.initials: R
authors.lastname: Wityk
authors.forename: Ta
authors.initials: T
authors.lastname: Glass
authors.forename: J
authors.initials: J
authors.lastname: Tapia
authors.forename: L
authors.initials: L
authors.lastname: Pazdera
authors.forename: H-M
authors.initials: HM
authors.lastname: Chang
authors.forename: Jf
authors.initials: J
authors.lastname: Dashe
authors.forename: Cj
authors.initials: C
authors.lastname: Chaves
authors.forename: K
authors.initials: K
authors.lastname: Vemmos
authors.forename: M
authors.initials: M
authors.lastname: Leary
authors.forename: Ld
authors.initials: L
authors.lastname: Dewitt
authors.forename: Ms
authors.initials: M
authors.lastname: Pessin
references.citation: J Neurol Neurosurg Psychiatry. 1977 Dec;40(12):1182-9
references.pmid: 591986
references.citation: J Neurol Sci. 1976 May;28(1):83-102
references.pmid: 932774
references.citation: Cerebrovasc Dis. 2000 Mar-Apr;10(2):133-41
references.pmid: 10686452
references.citation: Neuroradiology. 1979 Aug 15;18(2):83-91
references.pmid: 471228
references.citation: Aust N Z J Med. 1983 Feb;13(1):57-64
references.pmid: 6576747
references.citation: Ann Neurol. 2004 Sep;56(3):389-98
references.pmid: 15349866
references.citation: AMA Arch Neurol Psychiatry. 1954 Aug;72(2):187-204
references.pmid: 13180055
references.citation: J Neuropathol Exp Neurol. 1961 Jul;20:323-79
references.pmid: 13699936
references.citation: Neurology. 1989 Jan;39(1):9-16
references.pmid: 2909918
references.citation: Arch Neurol. 1975 Jun;32(6):357-63
references.pmid: 1131069
references.citation: Cerebrovasc Dis. 2000 Jul-Aug;10(4):261-71
references.pmid: 10878430
references.citation: Neurology. 1992 Aug;42(8):1505-12
references.pmid: 1641144
references.citation: AMA Arch Neurol Psychiatry. 1951 Mar;65(3):346-77
references.pmid: 14810286
references.citation: Arch Neurol. 1998 Apr;55(4):470-8
references.pmid: 9561974
references.citation: Neurology. 1993 Aug;43(8):1528-33
references.pmid: 8351006
references.citation: Neurology. 1978 Aug;28(8):754-62
references.pmid: 567291
references.citation: Arch Neurol. 1993 Feb;50(2):154-61
references.pmid: 8431134
references.citation: Bull New Engl Med Cent. 1953 Jun;15(2):53-60
references.pmid: 13051693
references.citation: Neurology. 1978 Nov;28(11):1141-4
references.pmid: 568733
references.citation: Arch Neurol. 2002 Mar;59(3):359-60
references.pmid: 11890837
references.citation: Arch Neurol. 1998 Nov;55(11):1475-82
references.pmid: 9823834
references.citation: Stroke. 1986 Nov-Dec;17(6):1277-81
references.pmid: 3810731
references.citation: Ann Neurol. 1987 Jan;21(1):85-9
references.pmid: 3827217
references.citation: J Am Med Assoc. 1958 Feb 8;166(6):587-92
references.pmid: 13502031
references.citation: Stroke. 1992 Feb;23(2):165-70
references.pmid: 1561642
references.citation: Stroke. 1985 Nov-Dec;16(6):1030-8
references.pmid: 4089921
references.citation: Brain. 1956 Jun;79(2):319-31
references.pmid: 13364085
references.citation: Neurology. 1958 May;8(5):311-32
references.pmid: 13541633
references.citation: Stroke. 1982 Jan-Feb;13(1):3-11
references.pmid: 7039002
references.citation: Brain. 1946 Jun;69(2):73-121
references.pmid: 20274363
references.citation: Stroke. 2001 Nov;32(11):2559-66
references.pmid: 11692017
references.citation: Br Med J. 1964 Jan 11;1(5375):84-6
references.pmid: 14075154
references.citation: Neurology. 1989 Sep;39(9):1246-50
references.pmid: 2671793
references.citation: Stroke. 1994 Jan;25(1):105-12
references.pmid: 8266355
references.citation: Stroke. 1987 Nov-Dec;18(6):1037-47
references.pmid: 3318002
references.citation: Ann Neurol. 1981 Aug;10(2):127-48
references.pmid: 7283400
references.citation: Neurology. 1988 Jun;38(6):868-77
references.pmid: 3368067
references.citation: J Neurol Neurosurg Psychiatry. 1996 Mar;60(3):289-96
references.pmid: 8609506
references.citation: Stroke. 2000 May;31(5):1062-8
references.pmid: 10797166
references.citation: Stroke. 1988 Sep;19(9):1083-92
references.pmid: 3413804
references.citation: Arch Neurol. 1999 Nov;56(11):1353-8
references.pmid: 10555655
references.citation: Stroke. 1988 May;19(5):547-54
references.pmid: 3363586
references.citation: Brain. 1990 Feb;113 ( Pt 1):139-55
references.pmid: 2302529
references.citation: Neurology. 1971 Sep;21(9):900-5
references.pmid: 5106254
references.citation: Rev Neurol (Paris). 1989;145(4):277-86
references.pmid: 2660219
references.citation: Stroke. 1983 Jul-Aug;14(4):530-6
references.pmid: 6658927
references.citation: JAMA. 1998 Apr 22-29;279(16):1265-72
references.pmid: 9565006
references.citation: Arch Neurol. 1999 Jul;56(7):824-32
references.pmid: 10404984
references.citation: Neurology. 1989 Jan;39(1):16-21
references.pmid: 2909908
references.citation: Stroke. 2000 Aug;31(8):2011-23
references.pmid: 10926972
references.citation: Stroke. 1999 Dec;30(12):2513-6
references.pmid: 10582970
references.citation: Neurology. 1967 Jun;17(6):614-7
references.pmid: 6067394
references.citation: Eur Neurol. 1997;38(1):10-20
references.pmid: 9252793
references.citation: Stroke. 1984 Jul-Aug;15(4):740-6
references.pmid: 6464070
references.citation: J Neuroimaging. 1995 Jan;5(1):1-3
references.pmid: 7849366
references.citation: Radiology. 1994 Jan;190(1):105-10
references.pmid: 8259384
references.citation: Cerebrovasc Dis. 2001;11(4):311-6
references.pmid: 11385210
references.citation: Arch Neurol. 1999 Jul;56(7):835-8
references.pmid: 10404985
references.citation: Neurology. 1990 Sep;40(9):1383-90
references.pmid: 2392223
references.citation: Arch Neurol. 2002 Mar;59(3):369-76
references.pmid: 11890839
references.citation: Neurology. 1992 Sep;42(9):1820-2
references.pmid: 1513475
references.citation: Proc Staff Meet Mayo Clin. 1955 Mar 23;30(6):116-26
references.pmid: 14371745
references.citation: Stroke. 1999 Feb;30(2):363-70
references.pmid: 9933272
references.citation: Stroke. 1977 May-Jun;8(3):383-90
references.pmid: 860293
references.citation: Neurology. 1991 Jun;41(6):855-9
references.pmid: 2046930
references.citation: J Anat Physiol. 1916 Jan;50(Pt 2):131-64
references.pmid: 17233055
references.citation: Proc Staff Meet Mayo Clin. 1955 Feb 23;30(4):61-8
references.pmid: 14357427
references.citation: Ann Neurol. 1987 Mar;21(3):290-9
references.pmid: 3606035
references.citation: Neurology. 1956 Jun;6(6):402-19
references.pmid: 13322174
references.citation: Q J Med. 1963 Oct;32:279-96
references.pmid: 14072148
references.citation: Neurology. 1988 Jun;38(6):880-5
references.pmid: 3368069
references.citation: Med Chir Trans. 1863;46:121-140.1
references.pmid: 20896209
references.citation: Stroke. 1990 Sep;21(9):1299-305
references.pmid: 2396267
references.citation: Eur Neurol. 1997;37(3):157-68
references.pmid: 9137926
references.citation: Clin Exp Neurol. 1991;28:1-22
references.pmid: 1821819
references.citation: Stroke. 1996 May;27(5):875-81
references.pmid: 8623107
references.citation: Neurology. 1990 Feb;40(2):281-4
references.pmid: 2300250
references.citation: Neurology. 1965 Jan;15:76-80
references.pmid: 14257831
references.citation: J Neurol Sci. 1976 May;28(1):103-13
references.pmid: 932770
references.citation: Mayo Clin Proc. 1997 Nov;72(11):1005-13
references.pmid: 9374973
references.citation: Eur Neurol. 1997;37(3):146-56
references.pmid: 9137925
references.citation: Neurology. 1980 Jan;30(1):72-9
references.pmid: 7188637
references.citation: Stroke. 1988 Oct;19(10):1216-22
references.pmid: 3176080
references.citation: Arch Neurol. 1978 Mar;35(3):126-8
references.pmid: 629655
references.citation: Brain. 1962 Dec;85:741-74
references.pmid: 14000840