CLINICAL STUDY OF POSTERIOR CIRCULATION STROKES IN A TERTIARY CARE CENTRE IN SOUTHERN INDIA

Nithyanandam A; Shanmuga Sundaram N; Dhanya T S; Chandramouleswaran V; Lakshmi Narasimhan R

Volume : X, Issue : I, January - 2020

CLINICAL STUDY OF POSTERIOR CIRCULATION STROKES IN A TERTIARY CARE CENTRE IN SOUTHERN INDIA

Nithyanandam A, Shanmuga Sundaram N, Dhanya T S, Chandramouleswaran V, Lakshmi Narasimhan R

Abstract :

Objective To Study the Clinical profile of patients diagnosed to have Posterior Circulation strokes and to assess the disability in posterior circulation stroke Material and Methods This is a cross sectional study, that included 202 patients, Data of all the patients diagnosed to have posterior circulation stroke by imaging has been documented in predetermined proforma including the clinical presentation, etiology and modified Rankin scale for disability assessment at discharge. RESULTS Ischemic strokes constitute 69.8% (141 cases) of posterior circulation strokes and hemorrhagic strokes 30.2% (61cases). Ischemic stroke is more in males (72.34%) than females (27.66%). Hemorrhagic stroke also more in males (65.57%) compared to females (34.43%). In patients with systemic Hypertension 67.25% had ischemic strokes 32.74% had hemorrhage. DISCUSSION: Incidence of posterior circulation strokes of 11.32% is comparable to previous studies. Posterior circulation strokes are more common between the ages of 45 to 65. Ischemic strokes constitute majority of PCS, with predominance for males. The incidence of ischemic strokes is higher (69.8%) than hemorrhagic strokes which are in accordance with other studies. Systemic Hypertension was the most common risk factor, causing more Ischemic than hemorrhagic strokes. About 27.72% had favorable MRS of 1–2 at the time of discharge. Another 37.13% had MRS of about 3–4 mainly due to still persisting motor manifestations of unsteadiness. The remaining MRS 5 (30.69%) had severe motor and swallowing disability, bedridden state requiring supportive home care. Mortality of 4.46 % was seen in MRS 6 patients. CONCLUSION Hemiplegia was the most common symptom followed by ataxia and visual field defects was the least common symptom, Most of the patients had nonspecific symptoms like headache, vomiting, giddiness and altered sensorium which points that high index of suspicion is needed to diagnose posterior circulation stroke. 27.72% had favorable MRS of 1–2 at the time of discharge.