Distribution of intracranial vascular lesions in the posterior circulation among Chinese stroke patients

Distribution of atherosclerotic vascular lesions in the intracranial posterior circulation has not been as well documented as in the anterior circulation. Data regarding this aspect among Asian stroke patients are scarce. In present study, we sought to investigate the distribution of posterior circulation vascular lesions in Chinese stroke patients. We examined consecutive patients with acute ischemic stroke on intracranial vertebral artery and basilar artery with transcranial Doppler ultrasonography. Those (N=33) with abnormalities in vertebrobasilar territory were selected for further study with magnetic resonance angiography and magnetic resonance imaging. Thirty-one of 33 patients were confirmed by magnetic resonance angiography with intracranial posterior vascular lesions. Magnetic resonance angiography findings showed 35% of the patients had lesions in the unilateral or bilateral intracranial vertebral artery without basilar artery involvement. One patient (3%) had an isolated lesion in basilar artery. More than 60% had lesions in basilar artery as well as intracranial vertebral artery. Fifty-two percent of patients had infarct foci within the posterior circulation territory. Infarction occurred most frequently at the pons and cerebellum. In conclusion, Chinese stroke patients have diffuse vascular lesions in the vertebrobasilar territory, rather than a discrete lesion. With the advent of noninvasive neuroimaging techniques, transcranial Doppler ultrasonography (TCD), magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) have been used more and more widely, making detection of posterior circulation vascular lesions attainable. We aimed to assess the distribution of intracranial vascular lesions in posterior circulation among consecutive Chinese acute stroke patients.