A comparative study of anterior versus posterior circulation cerebral infarctions: Clinical outcomes

Abstract

Introduction: Due to the lack of comprehensive study about the differences between posterior circulation infarction (PCI) and anterior circulation infarction (ACI), this study is performed to determine the clinical consequences of PCI and ACI. Methods: The required information was retrieved from the Tabriz Stroke Registry. Modified Rankin Score (mRS), National Institutes of Health’s Stroke Scale/Score (NIHSS) for severity, and Acute Stroke Treatment (TOAST) classification for types of ischemic stroke as well as the data regarding the risk factors were considered. Results: 701 eligible patients were included in this study, of which 524 (74.75%) were patients with ACI stroke and 177 (25.24%) with PCI stroke. There was no statistically significant difference in terms of age (P=0.724), sex (P=0.559), and pre-stroke mRS (P=0.279). Cardioembolism (CE), undetermined etiology (ESUS), and large arterial stroke (LAA) showed higher incidence in ACI patients, where lacunar type was more prevalent in PCI patients (P=0.01). Hospital NIHSS were significantly different between ACI and PCI groups (P=0.001). Also, regarding the discharged NIHSS patients, there was a significant difference between the groups (P=0.023). Moderate stroke was prominent in both groups in hospitalized (PCI: 57.6% and ACI: 48.9%) and discharged NIHSS patients (PCI: 38.4% and ACI: 42.4%). Conclusion: ACI is about 3-times more prevalent than PCI. There is no relation between the incidence of ACI or PCI and the stroke risk factors. Three months’ mortality did not significantly differ between PCI and ACI.