Clinical presentation of posterior cerebral artery occlusions – Clinical rationale for a more aggressive therapeutic strategy?

Introduction: A proximal occlusion of the posterior cerebral artery (PCA) can affect patients severely and clinical outcome might be poor. Aim of this paper is to describe clinical presentation, diagnostic findings and outcome of patients suffering from ischemia in the PCA territory. Methods: We con...

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Autores principales:	Volker Maus, Sophia Rogozinski, Jan Borggrefe, Utako Birgit Barnikol, Muharrem Saklak, Anastasios Mpotsaris
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/fef2eaa70d244655a8c5fa01c7ecc020
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spelling	oai:doaj.org-article:fef2eaa70d244655a8c5fa01c7ecc0202021-11-04T04:33:21ZClinical presentation of posterior cerebral artery occlusions – Clinical rationale for a more aggressive therapeutic strategy?2405-650210.1016/j.ensci.2021.100368https://doaj.org/article/fef2eaa70d244655a8c5fa01c7ecc0202021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2405650221000605https://doaj.org/toc/2405-6502Introduction: A proximal occlusion of the posterior cerebral artery (PCA) can affect patients severely and clinical outcome might be poor. Aim of this paper is to describe clinical presentation, diagnostic findings and outcome of patients suffering from ischemia in the PCA territory. Methods: We conducted a retrospective analysis of clinically affected patients with imaging-based evidence of ischemia within in the PCA territory at a comprehensive stroke center over a six-year period. Clinical (including demographics, National Institutes of Health Stroke Scale, NIHSS, modified Rankin Sclae, mRS), imaging (including occlusion site and brain infarction) and therapeutic data were evaluated. A favorable outcome was defined as an mRS ≤2. Results: Two hundred thirty-five patients were clinically affected with evidence of PCA ischemia detected by cross-sectional imaging. One-hundred fourty-five patients demonstrated an occlusion of the PCA including 43/145 (30%) with P1 occlusion, 80/145 (55%) with P2 and 22/145 (15%) with P3 occlusion. The most frequent symptom was hemi−/ quadrantanopsia (181/235, 77%). Sixty-eight patients (29%) suffered from hemiparesis. The occurrence of a hemiparesis was associated with a P1 occlusion (27/43, 63% vs. 41/192, 21%; p < 0.0001). Hemi−/quadrantanopsia was less frequently associated with a P1 occlusion (26/43, 61% vs. 155/192, 81%; p = 0.0043). P1 occlusions more frequently showed thalamic infarction (28/43, 65% vs. 65/192, 34%; p < 0.0001). At discharge, patients with P1 occlusion more often showed a poor outcome (mRS > 2, 30/43, 70% vs. 55/192, 29%; p < 0.0001). Conclusion: Hemiparesis due to P1 occlusion is a common phenomenon in stroke patients and associated with a poor clinical outcome.Volker MausSophia RogozinskiJan BorggrefeUtako Birgit BarnikolMuharrem SaklakAnastasios MpotsarisElsevierarticleNeurology. Diseases of the nervous systemRC346-429ENeNeurologicalSci, Vol 25, Iss , Pp 100368- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Volker Maus Sophia Rogozinski Jan Borggrefe Utako Birgit Barnikol Muharrem Saklak Anastasios Mpotsaris Clinical presentation of posterior cerebral artery occlusions – Clinical rationale for a more aggressive therapeutic strategy?
description	Introduction: A proximal occlusion of the posterior cerebral artery (PCA) can affect patients severely and clinical outcome might be poor. Aim of this paper is to describe clinical presentation, diagnostic findings and outcome of patients suffering from ischemia in the PCA territory. Methods: We conducted a retrospective analysis of clinically affected patients with imaging-based evidence of ischemia within in the PCA territory at a comprehensive stroke center over a six-year period. Clinical (including demographics, National Institutes of Health Stroke Scale, NIHSS, modified Rankin Sclae, mRS), imaging (including occlusion site and brain infarction) and therapeutic data were evaluated. A favorable outcome was defined as an mRS ≤2. Results: Two hundred thirty-five patients were clinically affected with evidence of PCA ischemia detected by cross-sectional imaging. One-hundred fourty-five patients demonstrated an occlusion of the PCA including 43/145 (30%) with P1 occlusion, 80/145 (55%) with P2 and 22/145 (15%) with P3 occlusion. The most frequent symptom was hemi−/ quadrantanopsia (181/235, 77%). Sixty-eight patients (29%) suffered from hemiparesis. The occurrence of a hemiparesis was associated with a P1 occlusion (27/43, 63% vs. 41/192, 21%; p < 0.0001). Hemi−/quadrantanopsia was less frequently associated with a P1 occlusion (26/43, 61% vs. 155/192, 81%; p = 0.0043). P1 occlusions more frequently showed thalamic infarction (28/43, 65% vs. 65/192, 34%; p < 0.0001). At discharge, patients with P1 occlusion more often showed a poor outcome (mRS > 2, 30/43, 70% vs. 55/192, 29%; p < 0.0001). Conclusion: Hemiparesis due to P1 occlusion is a common phenomenon in stroke patients and associated with a poor clinical outcome.
format	article
author	Volker Maus Sophia Rogozinski Jan Borggrefe Utako Birgit Barnikol Muharrem Saklak Anastasios Mpotsaris
author_facet	Volker Maus Sophia Rogozinski Jan Borggrefe Utako Birgit Barnikol Muharrem Saklak Anastasios Mpotsaris
author_sort	Volker Maus
title	Clinical presentation of posterior cerebral artery occlusions – Clinical rationale for a more aggressive therapeutic strategy?
title_short	Clinical presentation of posterior cerebral artery occlusions – Clinical rationale for a more aggressive therapeutic strategy?
title_full	Clinical presentation of posterior cerebral artery occlusions – Clinical rationale for a more aggressive therapeutic strategy?
title_fullStr	Clinical presentation of posterior cerebral artery occlusions – Clinical rationale for a more aggressive therapeutic strategy?
title_full_unstemmed	Clinical presentation of posterior cerebral artery occlusions – Clinical rationale for a more aggressive therapeutic strategy?
title_sort	clinical presentation of posterior cerebral artery occlusions – clinical rationale for a more aggressive therapeutic strategy?
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/fef2eaa70d244655a8c5fa01c7ecc020
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Clinical presentation of posterior cerebral artery occlusions – Clinical rationale for a more aggressive therapeutic strategy?

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