Difference between Risk Factors of Common Ischemic Brain Strokes on Anterior and Posterior Circulation

Background and purpose: Ischemic brain stroke is one of the most common neurologic diseases and the second cause of death among adults. There is currently no information on the relationship between risk factors influencing anterior and posterior circulation. The most common ischemic strokes occur in the (anterior circulation) AC, while strokes occurring in the posterior circulation (PC) are more severe. We sought to explore the differences between risk factors of common ischemic brain strokes on AC and PC. Materials and methods: In this prospective descriptive study, we evaluated 200 patients referring to Sari Bualisina and Behshahr Imam Hospitals. Strokes in AC and PC were diagnosed by clinical and neuroimaging findings including brain CT Scanning and MRI. Pre-stroke cerebrovascular risk factors were recorded for each patient including hypertension, diabetes mellitus, hyperlipidemia, and smoking. Results: Among the patients 40.4% had hypertension, 45.2% were diabetic, 33.3% were hyperlipidemic, 14.7 % had ischemic heart disease and 7.7% were smokers. The effect of age and sex was not significant between circulations. The prevalence of hypertension as a major risk factor of stroke and diabetes mellitus was higher in patients with PC stroke compared to patients with AC stroke (P<0.05). The co effect of diabetes mellitus and hypertension did not have any significant effect on type of circulation. The prevalence of hyperlipidemia was five times higher in patients with AC stroke (P<0.05). No any significant difference was seen between smoking and ischemic heart diseases and the type of circulation. Conclusion: The prevalence of hypertension and diabetes mellitus as major risk factors of stroke resulted in more PC strokes. Therefore, controlling the risk factors is of great importance to reduce the rate of such strokes.