title: Etiology and Risk Factors of Posterior Circulation Infarction Compared with Anterior Circulation Infarction.
abstract: BACKGROUND
  Many clinicians regard posterior circulation infarction (PCI) as different from anterior circulation infarction (ACI), leading them to apply different treatments. Few studies have validated this practice by directly comparing the etiology and risk factors of PCI and ACI.
  
  
  METHODS
  We compared the etiology and risk factors of 2245 consecutive patients with a diagnosis of PCI or ACI confirmed by magnetic resonance imaging in the Chengdu Stroke Registry. Stroke etiology in each patient was classified according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria.
  
  
  RESULTS
  Our sample included 482 patients (21.5%) with PCI and 1763 (78.5%) with ACI. The most frequent etiology for both infarction types was small-artery occlusion, occurring in 37.6% of patients with PCI and 37.1% of those with ACI. Cardioembolism caused infarction in a significantly smaller proportion of patients with PCI (5.4%) than in patients with ACI (13.3%; odds ratio [OR] = .373; 95% confidence interval [CI], .245-.566). Frequencies of other stroke etiologies were similar between the 2 patient groups. Analysis of risk factor frequencies in the 2 groups showed hypertension to be the most common, occurring in 47.9% of patients in either group. Multivariable analysis identified 2 factors as conferring greater risk of PCI than ACI: male gender (OR = 1.392; 95% CI, 1.085-1.786) and diabetes mellitus (OR = 1.667; 95% CI, 1.275-2.180). The same analysis identified 2 factors as conferring greater risk of ACI: atrial fibrillation (OR = .530; 95% CI, .295-.951) and heart valve disease (OR = .433; 95% CI, .203-.922). Frequencies of other possible risk factors were similar between the 2 groups.
  
  
  CONCLUSIONS
  These findings suggest that PCI and ACI are more similar than different in their etiology and risk factors and that the 2 types of infarction should be treated based more on etiology and risk factors than on their posterior or anterior localization.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Quantao
authors.initials: Q
authors.lastname: Zeng
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Wendan
authors.initials: W
authors.lastname: Tao
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Lei
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China. Electronic address: wyplmh@hotmail.com.
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications; D002560:Cerebrovascular Circulation; D016009:Chi-Square Distribution; D002681:China; D048909:Diabetes Complications / Q000209:etiology; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D020762:Infarction, Posterior Cerebral Artery / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors
keywords: Posterior circulation infarction; anterior circulation infarction; etiology; risk factors