![aica and pica syndrome aica and pica syndrome](https://stat.ameba.jp/user_images/20210102/07/zatouyuki/d1/ff/j/o1080081014875716357.jpg)
Data on patients were collected through a retrospective hospital database search. This study was undertaken at the Neurology Department, Medical Faculty of Bezmialem Vakif University, between January 2012 and September 2014, with the participation of 227 eligible patients out of 274 subjects with an established diagnosis of brainstem infarction among a total population of 1,752 cases admitted with an ischemic stroke. A deeper insight into the underlying etiology may have utmost importance, particularly with regard to the establishment of secondary prevention strategies in patients experiencing ischemic stroke. In contrast, a good body of evidence exists as to the anatomical sites involved in embolic and hemodynamic infarcts in the anterior circulation. There is relatively scarce published literature on the association between the etiology and the site of the infarction in the arterial territories of the brainstem. It may be a challenging task to elucidate the association between etiology and infarct site due to different arterial supply to mesencephalon, pons, and medulla as well as due to the high frequency of normal variations, particularly in patients with brainstem involvement. POCI occur at a lower frequency than infarcts involving the anterior circulation. 1, 2 Brainstem infarctions develop as a result of posterior artery to artery embolism, cardioembolism, or involvement of the basilar artery (BA) and its branches due to hemodynamic causes, or manifest themselves as lacunar syndromes. Of the ischemic strokes, 25% involve the posterior circulation ischemic infarcts (POCI), and of these 60% and 40% occur in the brainstem and cerebellum, respectively. Strokes represent a major cause of morbidity and mortality worldwide, with ischemic strokes comprising 80%–90% of all strokes. Keywords: cerebrovascular disorders, stroke, brain infarction, brain stem infarctions In subjects with simultaneous infarcts at other sites in addition to the brainstem, there was a significantly higher co-occurrence of medullary infarcts with cerebellar infarcts, mesencephalic infarcts with posterior cerebral artery infarcts, and pons infarcts with anterior circulation and multiple infarcts.Ĭonclusion: Determination of risk factors and infarct localization as well as prediction of etiological parameters may assist in improving survival rates and therapeutic approaches. Also, ischemia due to dissection was more common in infarctions involving the medulla, especially the lateral medulla. Cardioembolic events were more common in patients with mesencephalic infarcts. Large arterial atherothrombosis was the predominant cause of the strokes in all anatomical sites, particularly in infarcts involving the pons. While anterior involvement was more common in the mesencephalon and pons, posterior and lateral involvement occurred more frequently in the medulla. However, a single patient (0.5%) had an infarction both at the mesencephalon and pons, 3 (1.5%) at the pons and medulla, and 1 (0.5%) at the mesencephalon, pons, and medulla. Results: Twenty-one (9%), 136 (60%), and 65 (29%) patients had an infarction only at the mesencephalon, pons, and medulla, respectively. Patients with adequate diagnostic data and 3-month follow-up visit were included in the study. Methods: A retrospective search of the patient database of our institution was performed for a total of 227 patients who were admitted to the Department of Neurology, Medical Faculty of Bezmialem Vakif University between January 2012 and September 2014. Gozde Baran, 1 Tugce Ozdemir Gultekin, 2 Oguz Baran, 3 Cigdem Deniz, 3 Salim Katar, 3 Gulsen Babacan Yildiz, 2 Talip Asil 2ġDepartment of Neurology, Sisli Hamidiye Etfal Research and Training Hospital, 2Department of Neurology, Bezmialem Vakif University, 3Department of Neurosurgery, Istanbul Research and Training Hospital, Istanbul, Turkeyīackground and purpose: To assess the anatomical distribution of the ischemic strokes of the brainstem, the effect of anatomical distribution on clinical features and prognosis, and the association between etiology and anatomical involvement.