Multiple infarcts in the posterior circulation: infarcts distribution, vascular malformation and prognosis / 中华神经科杂志

ABSTRACT

Objective To analyze infarcts distribution and vascular malformation in patients with multiple infarcts in the posterior circulation and to investigate their correlation with the disease prognosis.Methods Thirty-four patients who had more than one infarct in the posterior circulation as shown on MRI were enrolled in the study.The digital subtraction angiography (DSA) of aortic arch and whole brain were performed on all patients and the images were analyzed and re-evaluated by two senior clinicians respectively.All the patients were assessed using Modified Rankin Scale (MRS) at discharge and correlation of infarcts distribution and vascular malformation with prognosis was evaluated.Results Infarct lesions most often involved pons (22 patients) and the middle (pons and anterior inferior cerebellum) plus distal territories (rostral brainstem, superior cerebellum and occipital and temporal lobes, 12 patients).Vascular abnormality was found in 76.5% (26/34) of the patients.The common vascular lesions involved vertebral artery (14 patients), intracranial vertebral artery (13 patients) and basilar artery (7 patients).The incidence of poor prognosis was 20.6% with 17.6% the severe disability rate and 2.9% the mortality rate.Patients with multiple lesions in proximal, middle and distal territories or basilar artery were likely to have poor prognosis.Conclusion Vascular abnormality is the main etiological factor for multiple infarcts in the posterior circulation.Infarcts distribution and the location of vascular lesions were key factors in predicting prognosis.