title: Predisposing factors in posterior circulation infarcts: a vascular morphological assessment.
abstract: BACKGROUND
  The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts.
  
  
  METHODS
  Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas.
  
  
  RESULTS
  No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus.
  
  
  CONCLUSIONS
  Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving.
authors: Department of Radiology, Baskent University Faculty of Medicine, Hocacihan mah. Saray cad., No:1 Selcuklu, Konya, Turkey, 42080, drgokcencoban@gmail.com.
authors: Gökçen
authors: G
authors: Çoban
authors: Egemen
authors: E
authors: Çifçi
authors: Erkan
authors: E
authors: Yildirim
authors: Ahmet Muhteşem
authors: AM
authors: Ağıldere
mesh_terms: D000368:Aged; D063405:Anatomic Variation; D001488:Basilar Artery / Q000033:anatomy & histology; D016022:Case-Control Studies; D015984:Causality; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D014711:Vertebral Artery / Q000033:anatomy & histology; D014715:Vertebrobasilar Insufficiency / Q000209:etiology* / Q000473:pathology*