The great majority of pure PCA and PCA+ territory infarcts are caused by cardiac or intra-arterial embolism. Intrinsic PCA disease, vasoconstriction, and coagulopathy are less common causes of infarction.

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Stroke patients with cognitive impairment no dementia (CIND) moderate are at higher risk of developing dementia, while CIND mild patients are not at increased risk of developing dementia.

; and neurodegenerative diseases (including cognitive decline, dementia, and cerebral atrophy). [6][7][8] These findings further support the concept that microvascular pathology may play an important role in the development of a wide range of age-related brain diseases, such as stroke, dementia, and Alzheimer disease. These retinal microvascular changes not only may represent cerebral small-vessel damage 9,10 but also may be the result of downstream effects of proximal largeartery disease.11 Retinopathy signs are, however, relatively late indicators of target organ damage in the eye and probably Background and Purpose-Microvascular disease has been implicated in the pathogenesis of stroke. The retina provides a window to assess microcirculation noninvasively. We studied the association between quantitatively measured retinal microvascular characteristics and acute ischemic stroke. Methods-We conducted a case-control study with acute ischemic stroke patients recruited from a tertiary hospital in Singapore and controls from the Singapore Epidemiology of Eye Disease program matched by 10-year age strata, sex, and race. Strokes were classified using modified Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Retinal vascular parameters were measured from retinal fundus photographs using a computer program. Logistic regression models for stroke were constructed adjusting for age, sex, race, and additionally for smoking, hypertension, diabetes mellitus, and hypercholesterolemia.

Background and Purpose-There is some evidence that poststroke dementia, cognitive impairment no dementia (CIND), and mild cognitive impairment predict for poor outcomes such as dementia, death, and institutionalization. However, few studies have examined the prognostic value of CIND, CIND severity, and domain impairments in a poststroke cohort. Methods-A cohort of ischemic stroke patients with baseline cognitive assessments 3 months poststroke were followed up annually for outcomes of dependency, vascular events, and death for up to 5 years. Univariate and multivariate Cox proportional regression was performed to determine the ability CIND, CIND severity, and domain impairments to predict dependency, vascular outcomes, and death. Results-Four-hundred nineteen patients without dementia (mean age 60Ϯ11 years, 32% female) were followed for a mean of 3.2 years. Older age, diabetes, more severe strokes, CIND-mild, and CIND-moderate were independently predictive of dependency. There were no independent predictors of recurrent vascular events. Older age, diabetes, and CIND-moderate were independently predictive of death. In analyses of individual cognitive domains, impairments in visuomotor speed were independently predictive of dependency. Conclusions-In poststroke patients, CIND predicts dependency and death, while CIND severity discriminates patients with poor survival. Impairments in visuomotor speed independently predict dependency. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique Identifier: NCT00161070.(Stroke. 2011;42:883-888.)Key Words: dementia Ⅲ stroke Ⅲ mild cognitive impairment Ⅲ cognitive impairment no dementia D ementia, cognitive impairment no dementia (CIND), and mild cognitive impairment (MCI) have become increasingly prevalent in aging populations. CIND is a broad concept that has been used to define impairments in any objective cognitive domain in neuropsychological testing in the absence of dementia. 1 In community-based studies, CIND has been shown to predict for dementia, death, and institutionalization. 2 One study found that poststroke CIND is a negative predictor of survival. 3 Studies have also shown that poststroke dementia (PSD) increases the risk of recurrent vascular events. 4,5 However, no studies to date have examined the effect of CIND on poststroke recurrent vascular events or dependency. We hypothesize that CIND is associated with dependency, recurrent vascular events, and death following ischemic stroke.In a previous study from this cohort, 6 we have shown that CIND severity predicts incident dementia; CIND-mild patients shared a similar risk profile with patients with no cognitive impairment (NCI), and CIND-moderate patients experienced a 6-fold increase in the risk of incident dementia. Because PSD has been associated with recurrent vascular events 4 and death, 7 we hypothesize that a similar association may exist with CIND severity and outcomes after stroke.Previous studies that have examined the prognostic abilities of domain-specific impairments have found tha...

Background and Purpose-South Asians are the most prevalent ethnic group in the world. Intracranial disease is the most common vascular lesion worldwide. Methods-We prospectively studied 200 consecutive ethnic South Asian patients with acute ischemic stroke in Singapore. Results-Intracranial large-artery disease was prevalent among 54% of all stroke subtypes and was independently associated with hypertension and higher serum erythrocyte sedimentation rate. Conclusions-Among ethnic South Asian patients with ischemic stroke, intracranial large arteries are the predominant site of disease.

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