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April 3, 2012
Posterior circulation stroke accounts for about 20% of all ischemic strokes. Unlike the anterior circulation, the posterior circulation depends on one main artery. The basilar artery supplies most of the brainstem and the occipital lobes, and part of the cerebellum and thalami. Up to 80% of patients with basilar artery occlusion (BAO) have a poor outcome. Poor 1–month outcome after BAO can be reliably predicted by a simple model that includes older age, absence of hyperlipidemia (probably secondary to statin use), presence of prodromal minor stroke symptoms, higher NIHSS score, and longer time to treatment. Of note, only 30% of patients with BAO have a CT scan that shows a dense basilar artery.
1. Greving JP, Schonewille WJ, Wijman CAC, et al on behalf of the BASICS study group. Predicting outcome after acute basilar artery occlusion based on admission characteristics. Neurology 2012;78:1058–1063.
Disclosure: Dr. Karam serves on the editorial team for the Neurology Resident and Fellow Section.
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