Vol. 6, Issue 1, Part A (2024)

Background: Posterior circulation stroke (PCS) carries the worst prognosis among other stroke subtypes, with severe disability and death. Posterior circulation ischemic stroke (PCIS) represents 20% of total ischemic strokes and is liable for delayed or misdiagnosis. The objective of this work was to estimate the frequency of posterior circulation ischemic stroke in Tanta University Hospitals. As well as identify functional outcomes and mortality in PCS. 
Methods: This study was performed on 119 posterior ischemic patients submitted to CT brain, and MRI brain. Using the following scales: Glasgow Coma Score (GCS) and National Institute of Health Stroke Scale (NIHSS), Adam’s scale of posterior circulation ischemic stroke (ASPCS). 
Results: PCIS represents19.8% of all ischemic strokes in ER. The mean of NIHSS in PCIS is lower than the mean of NIHSS in ACIS. Fast negative symptoms (vertigo, ataxia, and ocular manifestations are more common in PCIS while motor weakness and language are common in ACIS. Pontine lacunar infarction was the common site in PCIS, cerebellum, midbrain, occipital lobe, and thalamus. DWI-PC-ASPECTS mean was less than the PC-ASPECTS CT brain mean. (13.45%) of our patients received IVT and none received mechanical thrombectomy. PCIS had unfavorable outcomes in 70% of studied patients, the mRS mean was (3) and 18% of them died during follow-up. 
Conclusion: Posterior circulation ischemic stroke is a serious neurological emergency that can be life-threatening and has symptoms that are complicated and change over time. In determining the severity of PCIS, the PC-ASPECTS, and notably the DWI-PC-ASPECTS, are more accurate than the NIHSS. Both the prognosis and death rates were greater in PCIS than in ACIS.