One-year follow-up in patients with brainstem infarction due to large-artery atherothrombosis.
BACKGROUND
Posterior circulation infarction accounts for approximately 25% of the ischemic strokes. A number of different conditions may be associated with the development of brainstem infarction. Prognosis and recurrence rate of brainstem infarction due to large-artery atherothrombosis is still controversial.


METHODS
A total of 826 patients with ischemic stroke were admitted to our clinic during a 15-month period. Patients with clinical and radiological evidence of brainstem infarction were comprehensively assessed with appropriate vascular imaging modalities and for cardiological causes. Subjects with an established diagnosis of large-artery atherothrombosis were followed up for 1 year in terms of prognosis and recurrence rates.


RESULTS
Of the 101 patients with an established brainstem infarction, the diagnostic work-up indicated the presence of large-artery atherothrombosis as the causative factor in 53. A recurrent stroke was detected in the posterior circulation within the first 3 months in 5.8% and within 1 year in 9.8% of these individuals. The 1-year mortality rate was 11.7%. All patients with recurrent stroke had intracranial vascular narrowing at baseline.


CONCLUSIONS
Our findings demonstrate a particularly high rate of recurrence and mortality at 1 year among patients who have a brainstem infarction due to intracranial arterial stenosis.
Department of Neurology, Bezmialem Vakıf University, Istanbul, Turkey.
Mehmet
M
Kolukısa
Department of Neurology, Bezmialem Vakıf University, Istanbul, Turkey.
Tugce
T
Ozdemir Gültekin
Department of Neurology, Bezmialem Vakıf University, Istanbul, Turkey.
Gozde
G
Eryigit Baran
Department of Radiology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
Ayse
A
Aralasmak
Department of Neurology, Bezmialem Vakıf University, Istanbul, Turkey.
Gülsen
G
Kocaman
Department of Neurology, Bezmialem Vakıf University, Istanbul, Turkey.
Azize Esra
AE
Gürsoy
Department of Neurology, Bezmialem Vakıf University, Istanbul, Turkey.
Talip
T
Asil
basilar artery; extracranial arteries; intracranial arteries; posterior circulation; stroke; vertebral artery