Document Detail


Basilar artery occlusive disease in stroke survivors in a multiethnic population.
MedLine Citation:
PMID:  20047790     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To describe clinical, radiological findings, and outcome in a multiethnic population of stroke survivors with basilar artery occlusive disease (BAOC). METHODS: Forty patients with infarcts in the basilar artery (BA) territory, alive 30 days after the ictus, participated in the study. BA stenosis (>50%) or occlusion was shown by magnetic resonance or digital subtraction angiography in all patients. Demographical, clinical and radiological characteristics were described. Modified Rankin Scale (MRS) scores at 30 days and 6 months after the ischemic event were evaluated. Association between demographical, clinical, radiological features and outcome were analyzed with Chi-square and Fisher's exact tests. MRS scores at 30 days and 6 months were compared with the Wilcoxon test. RESULTS: Sixty percent of the patients were men, and 33% were Afro-Brazilian. Mean age was 55.8+/-12.9 years. Most (90%) had multiple vascular risk factors. Stroke was preceded by TIA in 48% of the patients, and 80% had a history of arterial hypertension. The most common neurological symptom was vertigo/dizziness (60%) and the sign, hemiparesis (60%). Most of the infarcts were located in the pons (85%) and the BA middle third was the most frequently affected segment (33%). BA occlusion occurred in 58% of the patients. More severe vascular occlusive lesions were present in Whites (p=0.002) and in patients with involvement of the middle third of the BA (p=0.021). Large-artery atherosclerosis was the most common stroke etiology (88%) and was more frequent in older patients (p<0.001). Most patients were treated with anticoagulation. MRS scores improved significantly at 6 months (p<0.001); at this time, 78% of the patients had MRS scores between 0 and 2. CONCLUSIONS: We observed different results compared with other series: greater proportion of Afro-descendents, higher frequency of atherosclerosis and BA occlusion. Rates of preceding TIAs and good outcome at 6 months were similar to previously published data. These results represent a step forward towards understanding BAOC in a multiethnic context.
Authors:
Jovana Gobbi Marchesi Cir?aco; Claudia da Costa Leite; Maria a Gra?a Morais dMartin; Cristiano Venturim Barros; Paulo Puglia; Jos? Guilherme Pereira Caldas; Milberto Scaff; Adriana Bastos Conforto
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-04
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  112     ISSN:  1872-6968     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-02     Completed Date:  2010-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  233-6     Citation Subset:  IM    
Affiliation:
Neurology Department, Hospital das Cl?nicas, S?o Paulo University, S?o Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adult
African Continental Ancestry Group / statistics & numerical data
Age Factors
Aged
Arterial Occlusive Diseases / complications,  epidemiology*,  ethnology,  physiopathology
Brazil / epidemiology
Cerebral Angiography
Dizziness / etiology
Female
Follow-Up Studies
Humans
Hypertension / complications,  physiopathology
Ischemic Attack, Transient / epidemiology*,  ethnology,  physiopathology
Male
Middle Aged
Paresis / etiology
Risk Factors
Stroke / etiology*,  physiopathology,  radiography
Survivors / statistics & numerical data*
Vertebrobasilar Insufficiency / complications,  epidemiology*,  ethnology,  radiography
Vertigo / etiology

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