Patterns of Ischemic Posterior Circulation Strokes: A Clinical, Anatomical, and Radiological Review
Authors: Alexander Salerno, Davide Strambo, Stefania Nannoni, Vincent Dunet, and Patrik Michel
Journal: International Journal of Stroke
Conclusions:
- Posterior circulation stroke syndromes closely reflect lesion localization and arterial occlusion patterns.
- Although they share many features with anterior circulation strokes, notable differences exist in terms of clinical presentation, stroke mechanism, prognosis, and response to acute recanalization.
- Timely and accurate diagnosis, particularly using MRI, is essential for managing these strokes and making informed revascularization decisions.
Methods:
- The authors conducted a literature review on clinical stroke syndromes and neuroimaging findings.
- The review systematically details clinical and radiological information for each anatomical site of stroke, including anatomical representation, diffusion-weighted imaging, and angiographic sequences.
- Principles of neuroimaging of posterior circulation strokes and the prognosis for each stroke localization are discussed.
Review Summary:
- The review presents stroke syndromes in the territories of vertebral, basilar, cerebellar, and posterior cerebral arteries.
- Features typical of posterior circulation strokes, including patterns of basilar artery occlusions, are highlighted.
- Clinical severity and prognosis of posterior circulation strokes are highly variable.
- These strokes are more challenging to detect on CT-based neuroimaging; hence, magnetic resonance imaging (MRI) is the preferred technique for suspected posterior circulation strokes.
- Rapid identification of arterial occlusion patterns can provide prognostic information and aid acute revascularization decisions.
Salerno, A., Strambo, D., Nannoni, S., Dunet, V. and Michel, P., 2022. Patterns of ischemic posterior circulation strokes: A clinical, anatomical, and radiological review. International Journal of Stroke, 17(7), pp.714-722.