Recognition of posterior circulation stroke.
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| Title: | Recognition of posterior circulation stroke. |
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| Authors: | Puustjärvi, V., Strbian, D., Tiainen, M., Curtze, S., Tatlisumak, T., Sairanen, T. |
| Source: | Acta Neurologica Scandinavica. Jun2015, Vol. 131 Issue 6, p389-393. 5p. |
| Subjects: | Stroke patients, Thrombolytic therapy, Ischemia, Hypertension, Patients, Blood circulation, Drug therapy, Warfarin |
| Abstract: | Objectives Better identification and triage of acute posterior circulation ( PC) stroke patients is needed as the PC ischemic stroke ( IS) patients may be allowed longer thrombolysis window than anterior circulation ( AC) IS patients and PC patients with hemorrhagic stroke ( ICH) may require care in a neurosurgical unit possibly remote from stroke unit. Materials and methods Consecutive stroke patients treated at a tertiary center with thrombolysis (100% for IS) and/or comprehensive stroke unit care. Results Altogether, 1641 patients had AC (75%) and 553 PC strokes. The PC- IS patients were younger (65 vs 70), had less often prior hypertension (51 vs 61%), and were twice more often on warfarin. They presented 3.5 times more often with seizure, vomited five times more often, had headache twice as often, and required intubation 2 to 3 times more often despite equal NIHSS (9 vs 8) or GCS (15 both) scores with AC- IS patients. Among PC patients, IS (n = 190) associated with younger age, prior atrial fibrillation ( AF) in 25% and dyslipidemia in ~40%. One-third of PC- ICH patients (n = 363) had headache and vomited at the onset. PC- ICH patients had BP median of 177/92 mmHg and blood glucose 7.4 mmol/l on ER arrival. Warfarin use was twice as common in PC- ICH. Conclusions Despite being of typical age for multiple cardiovascular conditions the PC- ICH patients less often have a previous history of AF or dyslipidemia than IS patients do. The vomiting PC- ICH patient with hypertensive BP values often has headache and a red flag for hemorrhage is warfarin treatment. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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