Please use this identifier to cite or link to this item: 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
Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
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
metadata.dc.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: http://ahro.austin.org.au/austinjspui/handle/1/22067
DOI: 10.1007/s00415-019-09613-5
ORCID: 0000-0003-1452-2064
0000-0002-6614-8417
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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