Abstract:  Objective To investigate risk factors, stroke mechanisms and infarct patterns of anterior and posterior circulation in ischemic stroke (IS) patients caused by intracranial atherosclerotic stenosis (ICAS). Methods Data of 257 ICSA related IS patients admitted to the department of neurology in our hospital were retrospectively collected from December 2014 to December 2017. According to the location of responsible vessel, all patients were divided into anterior circulation group (n=170) and posterior circulation group (n=87). The clinical data of those patients were collected. The risk factors, stroke mechanisms and infarct patterns were analyzed and compared between the two groups. Results (1) The proportion of male and smoking history was separately higher in anterior circulation group than that in posterior circulation group, while the proportion of hypertension and diabetes, and the level of HbA1c were lower in anterior circulation group than those of posterior circulation group (P＜0.05). Binary logistic regression analysis revealed that hypertension, diabetes and high level of HbA1c were independent risk factors for IS patients caused by intracranial posterior circulation atherosclerotic stenosis. (2) The proportion of hemodynamic impairment and multiple mechanisms were higher in anterior circulation group than those of posterior circulation group, but the proportion of local branch occlusion was lower in anterior circulation group than that of posterior circulation group (P＜0.05). (3) The proportion of single corticosubcortical infarction was higher in anterior circulation group than that of posterior circulation group, however, the proportion of single subcortical infarction was lower than posterior circulation group (P＜0.05). Conclusion There are differences in risk factors, stroke mechanisms and lesion patterns between anterior and posterior circulation in IS patients caused by ICAS. The development of different control strategies for different parts of blood vessels may be beneficial to reduce the occurrence of related IS.

Key words:  stroke, atherosclerosis, infarction, intracranial atherosclerotic stenosis, anterior circulation, posterior circulation