الفهرس 
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Abstract
The purpose of this study was to detect the relationship between different vascular risk factors and different infarction patterns in posterior cerebral circulation. This was cross sectional observational prospective hospital based study conducted on 60 patients (33 males and 27 females) with first ever acute posterior circulation ischemic stroke. Patients were recruited from the stroke unite of Ain Shams university and El Sahel teaching hospitals. The study population was divided into three groups according to the infarction pattern. Infarction patterns were categorized into a single small lacunar lesion (20 patients) (group I), a single large lesion (20 patients) (group II), and multiple scattered lesions (20 patients) (group III).
There was no significant difference between the three groups as regard the presence of vascular risk factors such as hypertension (P=0.153), diabetes (P=0.317),dyslipidemia (P=0.420), presence of cardiac diseases (P=0.180),and smoking (P=0.931). The only significant difference as regard vascular risk factors was AF. AF was present in 6 patients in group II and 6 patients in group III and not present in group I patients (P=0.024).
There was significant difference between the three groups as regard the occurrence of previous transient ischemic attacks (P=0.037).
There was significant difference between the three groups as regard NIHSS score on admission(P=0.010),after
24 hours (P= 0.003), and at 7 days from admission (P= 0.002). When comparing the NIHSS scores on admission to the scores after 7 days from onset of symptoms, it was noticed that there was significant decrease in the mean of NIHSS scores in group I and group II patients, while there was increase in the mean of NIHSS scores in group III patients .
There was significant differences between the three groups as regard mRS score at discharge (P= 0.003), and at 7 days follow up from the onset of symptoms (P= 0.024) and the degree of improvement from admission to discharge (P= <0.001).
When comparing the three groups, It was noticed that the degree of improvement and hence favorable functional outcome was the highest among group I population) followed by group II population and finally group III which had the least degree of improvement and hence poor functional outcome.
It was noticed that functional outcome after 7 days from onset of symptoms was significantly worse among group III population compared to groups I and group II (P=0.006).
There was significant differences between the three groups as regard duration of admission at hospital. When comparing the three groups, group III patients had the prolonged duration of admission at hospital in contrast to group II patients which had lower duration of admission to the hospital and group I patients which had the least duration of admission (P= <0.001).
There was no significant differences between the three groups as regard the result of echocardiography ejection fraction (P= 0.296).
There was significant difference between the three groups as regard volume of infarction in MRI . group II and group III patients had larger volumes of infarction when compared to group I patients (P= 0.004).There was no significant difference between the three groups as regard presence of significant intracranial stenosis in MRA (P=0.122).
There was significant difference between the three groups as regard stroke etiology .It was found that large artery atherosclerosis (LAA) was the most common stroke
etiology in posterior circulation being present in about 32 patients (53,3%) . It was present mainly in group II patients and group III patients in contrast to group I patients that had no stroke etiology due to LAA (P <0.001).
The laboratory results of the groups revealed that the significant difference between the three groups was platelets count (P= 0.020), random blood sugar on admission (P=0.049) and ESR (P=0.031). Admission hyperglycemia was associated with increase the risk of poor functional outcome and mortality.