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Stroke, Vol 23, 165-170, Copyright © 1992 by American Heart Association

ARTICLES

Clinical presentation as a guide to early prognosis in vertebrobasilar stroke

S Nadeau, J Jordan and S Mishra
Geriatric Research, Education and Clinical Center, Veterans Affairs Medical Center, Gainesville, FL 32608-1197.

BACKGROUND AND PURPOSE: This study attempts to assess the feasibility and heuristic value of a classification scheme for vertebrobasilar stroke. METHOD: Fifty-seven consecutive patients with vertebrobasilar stroke were classified on the basis of clinical features and computed tomographic abnormalities into single-sector (n = 19), multisector (n = 11), and top-of-the-basilar (n = 27) groups; a sector was defined as that portion of the brain stem supplied by a single penetrating (median) or branch (paramedian or lateral) artery. RESULTS: Thirty-day and 3-year survival rates were 100% and 71%, respectively, in the single-sector group, and 96% and 73%, respectively, in the top-of-the- basilar group. Thirty-day and 3-year stroke recurrence free survival rates were 89% and 76%, respectively, in the single-sector group, and 96% and 88%, respectively, in the top-of-the-basilar group. Seven of the 11 patients in the multisector group died within 2 months of ictus, three having experienced recurrence. CONCLUSIONS: These data, in part supported by prior studies, demonstrate the feasibility and heuristic value of the classification scheme and suggest that single-sector and top-of-the-basilar stroke patients have a relatively benign early prognosis and modest long-term stroke rates.

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