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AuthorImam, Yahia Z.
AuthorChandra, Prem
AuthorSingh, Rajvir
AuthorHakeem, Ishrat
AuthorAl Sirhan, Sally
AuthorKotob, Mona
AuthorAkhtar, Naveed
AuthorKamran, Saadat
AuthorAl Jerdi, Salman
AuthorMuhammad, Ahmad
AuthorHaroon, Khawaja Hasan
AuthorHussain, Suhail
AuthorPerkins, Jon D.
AuthorElalamy, Osama
AuthorAlhatou, Mohamed
AuthorAli, Liaquat
AuthorAbdelmoneim, Mohamed S.
AuthorJoseph, Sujatha
AuthorMorgan, Deborah
AuthorUy, Ryan Ty
AuthorBhutta, Zain
AuthorAzad, Aftab
AuthorAyyad, Ali
AuthorElsotouhy, Ahmed
AuthorOwn, Ahmed
AuthorDeleu, Dirk
Available date2024-04-25T06:20:13Z
Publication Date2024
Publication NameFrontiers in Neurology
ResourceScopus
ISSN16642295
URIhttp://dx.doi.org/10.3389/fneur.2024.1302298
URIhttp://hdl.handle.net/10576/54242
AbstractBackground: Posterior cerebral circulation ischemic stroke (PCS) comprises up to 25% of all strokes. It is characterized by variable presentation, leading to misdiagnosis and morbidity and mortality. We aim to describe PCS in large multiethnic cohorts. Methods: A retrospective review of a large national stroke database from its inception on the 1st of January 2014 till 31 December 2020. Incidence per 100,000 adult population/year, demographics, clinical features, stroke location, and outcomes were retrieved. We divided the cohort into patients from MENA (Middle East and North Africa) and others. Results: In total, 1,571 patients were identified. The incidence of PCS was observed to be rising and ranged from 6.3 to 13.2/100,000 adult population over the study period. Men were 82.4% of the total. The mean age was 54.9 ± 12.7 years (median 54 years, IQR 46, 63). MENA patients comprised 616 (39.2%) while others were 954 (60.7%); of these, the majority (80.5%) were from South Asia. Vascular risk factors were prevalent with 1,230 (78.3%) having hypertension, 970 (61.7%) with diabetes, and 872 (55.5%) having dyslipidemia. Weakness (944, 58.8%), dizziness (801, 50.5%), and slurred speech (584, 36.2%) were the most commonly presenting symptoms. The mean National Institute of Health Stroke Score (NIHSS) score was 3.8 ± 4.6 (median 3, IQR 1, 5). The overall most frequent stroke location was the distal location (568, 36.2%). The non-MENA cohort was younger, less vascularly burdened, and had more frequent proximal stroke location (p < 0.05). Dependency or death at discharge was seen in 39.5% and was associated with increasing age, and proximal and multilocation involvement; while at 90 days it was 27.4% and was associated with age, male sex, and having a MENA nationality (p < 0.05). Conclusion: In a multiethnic cohort of posterior circulation stroke patients from the MENA region and South Asia, we noted a rising incidence over time, high prevalence of vascular risk factors, and poor outcomes in older men from the MENA region. We also uncovered considerable disparities between the MENA and non-MENA groups in stroke location and outcome. These disparities are crucial factors to consider when tailoring individualized patient care plans. Further research is needed to thoroughly investigate the underlying reasons for these variations.
Languageen
PublisherFrontiers Media SA
Subjectclinical features
incidence
multiethnic
observational
outcomes
posterior circulation stroke
TitleIncidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database
TypeArticle
Volume Number15
dc.accessType Open Access


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