Posterior circulation infarction： distribution of lesions and CT angiography

Abstract

Objective To investigate the correlation between the distribution of lesions on MRI and the fnadings of computerized tomography angiography （CTA） in patients with posterior circulation infarction. Methods Patients with acute posterior circulation infarction were enrolled in the study. The sites of the infarcts were divided into proximal, middle and distal infarctions according to the results of MRI. All the patients received head and neck CTA. The correlation between the distrbution of posterior circulation infarcts and the sites of vertebrobasilar system lesions was analyzed. Results A total of 203 patients with acute posterior circulation infarction were enrolled. Their primary clinical symptoms and signs were unilateral limb weakness （n = 77, 37. 93%）, dizziness （n = 129, 63.55%）, dysarthrla （n = 31, 15.27%）, nausea and vomiting （n= 61, 30. 05%）, headache （n = 79, 38.92%）, gait abnormal （n= 50, 24. 63%）, nystagmus （n= 34, 16.75%）, and ataxia （n=21, 10.34%）. Proximal infarction （n= 35, 17.24%）：medullary infarction （n =28, 13.79%）, posterior inferior cerebellar artery infarction （n =7, 3.45%）; middle infarction （n =95, 46. 79% ）： pontine infarction （n = 80, 39.4% ）, anterior inferior cerebellar infarction （n = 15, 7.39%）; distal infarction （n= 73, 35.96%）： middle cerebral infarction （n= 6, 2.96%）, superior cerebellar infarction （n = 16, 7. 88% ）, thalamic infarction （n = 34, （16. 75% ）, occipital lobe infarction （n = 10, 4. 93%）, temporal lobe infarction （n= 7, 3.44%）. Extracranial vertebral artery lesions were most common in the distal infarction group. It reached 53.42%, and was significantly higher than 22.86% in the proximal infarction group （P =0. 003） and 33.68% in the middle infarction group （P =0. 010）. Intracranial vertebral artery lesions were most common in the proximal infarction group. It reached 57. 14%, and then followed by the middle infarction （41.05%）. They were all significantly higher than 15.07% in the distal infarction group （all P =0. 000）. Basilar artery lesions were most common in the middle infarction group. It reached 20.00% and was significantly higher than 4. 11% in the distal infarction group （P= 0.002）. Posterior cerebral artery lesions were most common in the distal infarction group. It reached 27.40% and was significantly higher than 5.71% in the proximal infarction group （P=0. 009） and 5.26% in the middle infarction group （P =0. 000）. Conclusions The range of vascular lesions of the distribution of lesions shown on MRI and the findings of CTA on vertebrobasilar artery system in patients with posterior circulation infarction had some connection. During the proximal and middle infarctions, the possibility of having intracranial vertebral artery lesions was greater; during the distal infarction, the poss~ility of having extracranial vertebral artery and posterior cerebral artery lesions was greater. Key words: Vertebrobasilar Insufficiency; Brain Infarction; Magnetic Resonance Imaging; CerebralAngiography; Tomography, X-Ray Computed