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https://ahro.austin.org.au/austinjspui/handle/1/22067| Title: | Detailed phenotyping of posterior vs. anterior circulation ischemic stroke: a multi-center MRI study. | Austin Authors: | Frid, Petrea;Drake, Mattias;Giese, A K;Wasselius, J;Schirmer, M D;Donahue, K L;Cloonan, L;Irie, R;Bouts, M J R J;McIntosh, E C;Mocking, S J T;Dalca, A V;Sridharan, R;Xu, H;Giralt-Steinhauer, E;Holmegaard, L;Jood, K;Roquer, J;Cole, J W;McArdle, P F;Broderick, J P;Jimenez-Conde, J;Jern, C;Kissela, B M;Kleindorfer, D O;Lemmens, R;Meschia, J F;Rundek, T;Sacco, R L;Schmidt, R;Sharma, P;Slowik, A;Thijs, Vincent N ;Woo, D;Worrall, B B;Kittner, S J;Mitchell, B D;Petersson, J;Rosand, J;Golland, P;Wu, O;Rost, N S;Lindgren, A | Affiliation: | Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden Department of Neurology and Rehabilitation Medicine, Neurology, Skåne University Hospital, Malmö, Sweden Department of Neurology, Skåne University Hospital, Jan Waldenströms gata 19, 205 02, Malmö, Sweden Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden Department of Radiology, Neuroradiology, Skåne University Hospital, Lund, Sweden J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden Department of Radiology, Neuroradiology, Skåne University Hospital, Lund, Sweden J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA Department of Population Health Sciences, German Centre for Neurodegenerative Diseases (DZNE), Bonn, Germany J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA Neurovascular Research Group (NEUVAS), Department of Neurology, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Barcelona, Spain Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden Neurovascular Research Group (NEUVAS), Department of Neurology, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Barcelona, Spain Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, USA Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA Neurovascular Research Group (NEUVAS), Department of Neurology, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autonoma de Barcelona, Barcelona, Spain Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Louvain, Belgium VIB Center for Brain and Disease Research, Louvain, Belgium Department of Neurology, University Hospitals Leuven, Louvain, Belgium Department of Neurology, Mayo Clinic, Jacksonville, FL, USA Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Clinical Division of Neurogeriatrics, Department of Neurology, Medical University Graz, Graz, Austria Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL), Egham, UK Ashford and St Peter's Hospital, Ashford, UK Department of Neurology, Jagiellonian University Medical College, Kraków, Poland The Florey Institute of Neuroscience and Mental Health Department of Neurology, Austin Health, Heidelberg, Victoria, Australia Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA Department of Neurology, University of Virginia, Charlottesville, VA, USA Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, USA Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, MD, USA Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden Department of Neurology and Rehabilitation Medicine, Neurology, Skåne University Hospital, Malmö, Sweden J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA Center for Genomic Research, Massachusetts General Hospital, Boston, MA, USA Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital, Boston, MA, USA Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, USA J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden Department of Neurology and Rehabilitation Medicine, Neurology, Skåne University Hospital, Lund, Sweden |
Issue Date: | Mar-2020 | Date: | 2019-11-11 | Publication information: | Journal of Neurology 2020; 267(3): 649-658 | Abstract: | Posterior circulation ischemic stroke (PCiS) constitutes 20-30% of ischemic stroke cases. Detailed information about differences between PCiS and anterior circulation ischemic stroke (ACiS) remains scarce. Such information might guide clinical decision making and prevention strategies. We studied risk factors and ischemic stroke subtypes in PCiS vs. ACiS and lesion location on magnetic resonance imaging (MRI) in PCiS. Out of 3,301 MRIs from 12 sites in the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Genetics Network (SiGN), we included 2,381 cases with acute DWI lesions. The definition of ACiS or PCiS was based on lesion location. We compared the groups using Chi-squared and logistic regression. PCiS occurred in 718 (30%) patients and ACiS in 1663 (70%). Diabetes and male sex were more common in PCiS vs. ACiS (diabetes 27% vs. 23%, p < 0.05; male sex 68% vs. 58%, p < 0.001). Both were independently associated with PCiS (diabetes, OR = 1.29; 95% CI 1.04-1.61; male sex, OR = 1.46; 95% CI 1.21-1.78). ACiS more commonly had large artery atherosclerosis (25% vs. 20%, p < 0.01) and cardioembolic mechanisms (17% vs. 11%, p < 0.001) compared to PCiS. Small artery occlusion was more common in PCiS vs. ACiS (20% vs. 14%, p < 0.001). Small artery occlusion accounted for 47% of solitary brainstem infarctions. Ischemic stroke subtypes differ between the two phenotypes. Diabetes and male sex have a stronger association with PCiS than ACiS. Definitive MRI-based PCiS diagnosis aids etiological investigation and contributes additional insights into specific risk factors and mechanisms of injury in PCiS. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/22067 | DOI: | 10.1007/s00415-019-09613-5 | ORCID: | 0000-0003-1452-2064 0000-0002-6614-8417 |
Journal: | Journal of Neurology | PubMed URL: | 31709475 | Type: | Journal Article | Subjects: | Magnetic resonance imaging Phenotyping Posterior circulation brain infarction Risk factors Stroke |
| Appears in Collections: | Journal articles |
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