New England Medical Center Posterior Circulation registry

Louis R. Caplan, Robert J. Wityk, Thomas A. Glass, Jorge Tapia, Ladislav Pazdera, Hui Meng Chang, Phillip Teal, John F. Dashe, Claudia J. Chaves, Joan C. Breen, Kostas Vemmos, Pierre Amarenco, Barbara Tettenborn, Megan Leary, Conrad Estol, L. Dana Dewitt, Michael S. Pessin

Research output: Contribution to journalArticle

Abstract

Among 407 New England Medical Center Posterior Circulation registry patients, 59% had strokes without transient ischemic attacks (TIAs), 24% had TIAs then strokes, and 16% had only TIAs. Embolism was the commonest stroke mechanism (40% of patients including 24% cardiac origin, 14% intraarterial, 2% cardiac and arterial sources). In 32% large artery occlusive lesions caused hemodynamic brain ischemia. Infarcts most often included the distal posterior circulation territory (rostral brainstem, superior cerebellum and occipital and temporal lobes); the proximal (medulla and posterior inferior cerebellum) and middle (pons and anterior inferior cerebellum) territories were equally involved. Severe occlusive lesions (>50% stenosis) involved more than one large artery in 148 patients; 134 had one artery site involved unilaterally or bilaterally. The commonest occlusive sites were: extracranial vertebral artery (52 patients, 15 bilateral) intracranial vertebral artery (40 patients, 12 bilateral), basilar artery (46 patients). Intraarterial embolism was the commonest mechanism of brain infarction in patients with vertebral artery occlusive disease. Thirty-day mortality was 3.6%. Embolic mechanism, distal territory location, and basilar artery occlusive disease carried the poorest prognosis. The best outcome was in patients who had multiple arterial occlusive sites; they had position-sensitive TIAs during months to years.

Original languageEnglish (US)
Pages (from-to)389-398
Number of pages10
JournalAnnals of Neurology
Volume56
Issue number3
DOIs
StatePublished - Sep 2004
Externally publishedYes

Fingerprint

New England
Registries
Transient Ischemic Attack
Vertebral Artery
Cerebellum
Basilar Artery
Arteries
Stroke
Embolism
Brain Infarction
Occipital Lobe
Pons
Temporal Lobe
Brain Ischemia
Brain Stem
Pathologic Constriction
Hemodynamics
Mortality

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Caplan, L. R., Wityk, R. J., Glass, T. A., Tapia, J., Pazdera, L., Chang, H. M., ... Pessin, M. S. (2004). New England Medical Center Posterior Circulation registry. Annals of Neurology, 56(3), 389-398. https://doi.org/10.1002/ana.20204

New England Medical Center Posterior Circulation registry. / Caplan, Louis R.; Wityk, Robert J.; Glass, Thomas A.; Tapia, Jorge; Pazdera, Ladislav; Chang, Hui Meng; Teal, Phillip; Dashe, John F.; Chaves, Claudia J.; Breen, Joan C.; Vemmos, Kostas; Amarenco, Pierre; Tettenborn, Barbara; Leary, Megan; Estol, Conrad; Dewitt, L. Dana; Pessin, Michael S.

In: Annals of Neurology, Vol. 56, No. 3, 09.2004, p. 389-398.

Research output: Contribution to journalArticle

Caplan, LR, Wityk, RJ, Glass, TA, Tapia, J, Pazdera, L, Chang, HM, Teal, P, Dashe, JF, Chaves, CJ, Breen, JC, Vemmos, K, Amarenco, P, Tettenborn, B, Leary, M, Estol, C, Dewitt, LD & Pessin, MS 2004, 'New England Medical Center Posterior Circulation registry', Annals of Neurology, vol. 56, no. 3, pp. 389-398. https://doi.org/10.1002/ana.20204
Caplan LR, Wityk RJ, Glass TA, Tapia J, Pazdera L, Chang HM et al. New England Medical Center Posterior Circulation registry. Annals of Neurology. 2004 Sep;56(3):389-398. https://doi.org/10.1002/ana.20204
Caplan, Louis R. ; Wityk, Robert J. ; Glass, Thomas A. ; Tapia, Jorge ; Pazdera, Ladislav ; Chang, Hui Meng ; Teal, Phillip ; Dashe, John F. ; Chaves, Claudia J. ; Breen, Joan C. ; Vemmos, Kostas ; Amarenco, Pierre ; Tettenborn, Barbara ; Leary, Megan ; Estol, Conrad ; Dewitt, L. Dana ; Pessin, Michael S. / New England Medical Center Posterior Circulation registry. In: Annals of Neurology. 2004 ; Vol. 56, No. 3. pp. 389-398.
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