{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:14:46Z","timestamp":1760955286604},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1996,8]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            Ischemic stroke patients whose initial clinical presentation suggests an involvement of the anterior circulation (AC) are sometimes found to have a posterior circulation (PC) infarct, a fact that may generate erroneous decisions in clinical management. We investigated the prevalence of this misdiagnosis in the first few hours after stroke onset.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            We performed a cohort study of 158 patients hospitalized within 5 hours of onset of a presumed AC ischemic stroke, as diagnosed on clinical grounds.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            Final CT or pathology diagnosis was AC infarct in 128 patients (81%), a repeatedly negative CT in 14 (9%), PC infarct (5 pons, 1 midbrain and cerebellum, 6 supratentorial territory of the posterior cerebral artery) in 12 (8%), and other or undiagnosed lesions in 4 (3%). AC and PC stroke patients did not differ in terms of age, vascular risk factors, and initial severity, but the latter were more frequently men (83% versus 53%;\n            <jats:italic>P<\/jats:italic>\n            =.04), were hospitalized later (mean\u00b1SD, 168\u00b186 versus 109\u00b155 minutes;\n            <jats:italic>P<\/jats:italic>\n            =.001), and presented a pure motor hemiparesis or a sensorimotor stroke (50% versus 33%) more often than their counterparts. At baseline CT, PC stroke patients never exhibited an early parenchymal hypodensity in the carotid territory or a hyperdense middle cerebral artery, which were instead found in 59% (\n            <jats:italic>P<\/jats:italic>\n            =.0003) and 31% (\n            <jats:italic>P<\/jats:italic>\n            =.02) of AC stroke patients, respectively. Early neurological deterioration, 1 month case-fatality rate, and disablement in survivors were comparable in the two groups.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            Shortly after onset the clinical discrimination between AC and nontypical PC infarcts is not reliable, which explains the frequent occurrence of this misdiagnosis. Emergency CT scan helps in the differential diagnosis only when it demonstrates an early focal hypodensity within the carotid territory.\n          <\/jats:p>","DOI":"10.1161\/01.str.27.8.1306","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"1306-1309","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Posterior Circulation Infarcts Simulating Anterior Circulation Stroke"],"prefix":"10.1161","volume":"27","author":[{"given":"Corrado","family":"Argentino","sequence":"first","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"De Michele","sequence":"additional","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Fiorelli","sequence":"additional","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danilo","family":"Toni","sequence":"additional","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Luisa","family":"Sacchetti","sequence":"additional","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Cavalletti","sequence":"additional","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuliano","family":"Sette","sequence":"additional","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Falcou","sequence":"additional","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Bastianello","sequence":"additional","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Bozzao","sequence":"additional","affiliation":[{"name":"the Department of Neurological Sciences, University \u201cLa Sapienza,\u201d Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","unstructured":"Caplan LR. Stroke: A Clinical Approach. 2nd ed. Boston Mass: Butterworth-Heinemann; 1995."},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.11.2197"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.41.3.385"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.40.10.1496"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)93206-O"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.17.4.3738958"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00344173"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1983.04050030032005"},{"key":"e_1_3_2_9_2","first-page":"61","volume":"21","year":"1965","unstructured":"Mahoney FJ, Barthel DW. Functional evaluation: the Barthel Index. Md Med J. 1965;21:61-65.","journal-title":"Md Med J"},{"key":"e_1_3_2_10_2","unstructured":"Dixon WJ ed. BMDP Statistical Software 1990 Release. Berkeley Calif: University of California Press; 1990."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1993.tb05350.x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.11.2032"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1988.00520360019004"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.19.10.3176080"},{"key":"e_1_3_2_15_2","first-page":"621","volume":"12","year":"1991","unstructured":"Yuh WT, Crain MR, Loes DJ, Greene GM, Ryals TJ, Sato Y. MR imaging of cerebral ischemia: findings in the first 24 hours. AJNR Am J Neuroradiol. 1991;12:621-629.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.23.5.1579963"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1977.00500240027004"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.8.1338"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.1.8266389"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.27.8.1306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:38:35Z","timestamp":1715553515000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.27.8.1306"}},"subtitle":["Perspective of the Acute Phase"],"short-title":[],"issued":{"date-parts":[[1996,8]]},"references-count":19,"journal-issue":{"issue":"8","published-print":{"date-parts":[[1996,8]]}},"alternative-id":["10.1161\/01.STR.27.8.1306"],"URL":"https:\/\/doi.org\/10.1161\/01.str.27.8.1306","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,8]]},"assertion":[{"value":"1996-01-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1996-05-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1996-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}