Posterior Circulation Ischemic Stroke—Clinical Characteristics, Risk Factors, and Subtypes in a North Indian Population

ABSTRACT Background: Posterior circulation stroke (PCS), though less common, differs from stroke in anterior circulation in many aspects. Relatively, it portends a poorer prognosis. However, there is a paucity of data from African countries, in particular, where stroke is a menace. Objective: The study aimed to evaluate the etiology, clinical characteristics, outcome, and predictors of outcome in a cohort of patients with IPCS in Northwestern Nigeria. Materials and Methods: Out of 595 patients with stroke, we prospectively analyzed 57 patients with PCS in a Tertiary Care Center in Kano, Northwestern Nigeria. Patients were analyzed for demographic data, risk factors, clinical characteristics, stroke subtypes, mortality, and predictors of mortality. Results: Posterior circulation ischemic stroke accounted for 57 (9.6%) of 595 of all strokes seen in the study period. They comprised 44 males (mean age 47.8 ± 17.7) and 13 females (mean age 46.3 ± 13.7). Overall, their age ranged between 24 and 90 (mean age 47.4 ± 16.7). However, 52.7% of the patients were < 45 years of age. The most common site affected was the cerebellum seen in 33 (57.9%) patients. Hypertension was the most common risk factor (86%). Headache and vertigo were the most common features accounting for 83.6% and 86.3%, respectively. Thirty-eight (66.7%) patients had an ischemic stroke. Twenty-one (36.8%) of the patients died during the 1-month period of follow-up. Independent predictors of death in the study were hyperglycemia on admission and hemorrhagic stroke. Conclusions: IPCS occurred in a relatively younger age group. Headache and vertigo were the most common symptoms. The independent predictors of death in the study were hyperglycemia at presentation and hemorrhagic stroke.

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Posterior Circulation Ischemic Stroke - Clinical Characteristics, Risk Factors and Subtypes: A Prospective Study (P07.029)

Neurology ◽

10.1212/wnl.78.1_meetingabstracts.p07.029 ◽

2012 ◽

Vol 78 (Meeting Abstracts 1) ◽

pp. P07.029-P07.029

Author(s):

R. Nayak ◽

M. Mehndiratta ◽

S. Pandey ◽

P. Mehndiratta

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Prospective Study ◽

Clinical Characteristics ◽

Posterior Circulation ◽

A Prospective Study

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Osteo-necrosis of femoral head in North Indian population: Risk factors and clinico-radiological correlation

Clinical Epidemiology and Global Health ◽

10.1016/j.cegh.2019.01.012 ◽

2019 ◽

Vol 7 (3) ◽

pp. 446-449 ◽

Cited By ~ 1

Author(s):

Tarun Goyal ◽

Anant Singh ◽

Rahul Sharma ◽

Arghya Kundu Choudhury ◽

Shobha S. Arora

Keyword(s):

Risk Factors ◽

Femoral Head ◽

Indian Population ◽

North Indian Population ◽

Necrosis Of Femoral Head

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OP0168 Clinical Characteristics, Case-Fatality and Risk Factors for Ischemic Stroke in Prevalent Rheumatoid Arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2014-eular.5346 ◽

2014 ◽

Vol 73 (Suppl 2) ◽

pp. 125.2-126

Author(s):

A. Mantel ◽

M. Holmqvist ◽

K. Asplund ◽

S. Wallberg-Jonsson ◽

J. Askling

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Ischemic Stroke ◽

Clinical Characteristics ◽

Case Fatality

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Clinical Spectrum, Risk Factors, and Behavioral Abnormalities among Dementia Subtypes in a North Indian Population: A Hospital-Based Study

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000478978 ◽

2017 ◽

Vol 7 (2) ◽

pp. 257-273 ◽

Cited By ~ 2

Author(s):

Suman Kushwaha ◽

Puneet Talwar ◽

Aldrin Anthony ◽

Meena Gupta ◽

Kiran Bala ◽

...

Keyword(s):

Risk Factors ◽

Rural Areas ◽

Indian Population ◽

Positive Family History ◽

Behavioral Pattern ◽

Clinical Spectrum ◽

North Indian Population ◽

Large Hospital ◽

Behavioral Abnormalities

Background: As variability in the clinical profile of dementia subtypes had been reported with regional differences across the world, we conducted a retrospective hospital-based study in a North Indian population. Methods: We retrieved patient records from 2007 to 2014 for details of clinical evaluation, diagnosis, neuroimaging, biochemical investigations, and follow-up of 1,876 patients with dementia (PwD), and the data were analyzed using descriptive statistics. Results: Of the total PwD, Alzheimer disease (AD) accounted for 30% followed by vascular dementia (VaD) 26%, mixed dementia (MD) 21%, Parkinson-related dementia 11%, frontotemporal dementia (FTD) 7%, and infective dementia 5%. Of all PwD excluding the infective group (n = 1,777), 63% were men, 39% were from rural areas, 87% had behavioral abnormalities along with cognitive deficits, and 73% had impaired ADLs. Among dementia subtypes, a positive family history, cardiovascular and metabolic risk factors, and behavioral abnormalities were found to be distributed. However, there existed a predominance of specific behavioral pattern in each subtype. The mean duration of follow-up varied from 2.9 ± 2.3 (VaD) to 3.6 ± 2.1 (AD) and greater than 30% were found to be stable on treatment (except in dementia with Lewy body). Conclusions: This large hospital-based study provides a distribution pattern and clinical spectrum of dementia subtypes in a North Indian population.

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Diagnosis of DWI-negative acute ischemic stroke

Neurology ◽

10.1212/wnl.0000000000004120 ◽

2017 ◽

Vol 89 (3) ◽

pp. 256-262 ◽

Cited By ~ 39

Author(s):

Brian L. Edlow ◽

Shelley Hurwitz ◽

Jonathan A. Edlow

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Clinical Diagnosis ◽

Clinical Characteristics ◽

Meta Analysis ◽

Reperfusion Therapy ◽

Posterior Circulation ◽

Anterior Circulation ◽

Ovid Medline ◽

Level Data

Objective:To determine the prevalence of diffusion-weighted imaging (DWI)–negative acute ischemic stroke (AIS) and to identify clinical characteristics of patients with DWI-negative AIS.Methods:We systematically searched PubMed and Ovid/MEDLINE for relevant studies between 1992, the year that the DWI sequence entered clinical practice, and 2016. Studies were included based upon enrollment of consecutive patients presenting with a clinical diagnosis of AIS prior to imaging. Meta-analysis was performed to synthesize study-level data, estimate DWI-negative stroke prevalence, and estimate the odds ratios (ORs) for clinical characteristics associated with DWI-negative stroke.Results:Twelve articles including 3,236 AIS patients were included. The meta-analytic synthesis yielded a pooled prevalence of DWI-negative AIS of 6.8%, 95% confidence interval (CI) 4.9–9.3. In the 5 studies that reported proportion data for DWI-negative and DWI-positive AIS based on the ischemic vascular territory (n = 1,023 AIS patients), DWI-negative stroke was strongly associated with posterior circulation ischemia, as determined by clinical diagnosis at hospital discharge or repeat imaging (OR 5.1, 95% CI 2.3–11.6, p < 0.001).Conclusions:A small but significant percentage of patients with AIS have a negative DWI scan. Patients with neurologic deficits consistent with posterior circulation ischemia have 5 times the odds of having a negative DWI scan compared to patients with anterior circulation ischemia. AIS remains a clinical diagnosis and urgent reperfusion therapy should be considered even when an initial DWI scan is negative.

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