Research Topic

Challenges in Posterior Circulation Ischemic Stroke

About this Research Topic

Posterior circulation ischemic stroke comprises around 15-20% of all ischemic strokes. An acute occlusion of the basilar artery triggers the most devastating ischemic stroke syndrome with altered consciousness, loss of brainstem reflexes, and tetraplegia. However, posterior circulation stroke is often hard to diagnose clinically as well as radiologically if magnetic resonance imaging is not available. The anatomy of the posterior circulation is highly variable and stroke syndromes within have distinct etiologies, risk factors, and ethnic distribution that might vary from the anterior circulation. Acute recanalization therapies, like intravenous thrombolysis and mechanical thrombectomy, have been studied less in patients with posterior circulation stroke and the outcome of patients tends to be worse than that of patients with anterior circulation stroke.

Acute posterior circulation ischemic stroke varies from anterior circulation stroke in many ways. The goal of this Research Topic is to cover all aspects of acute posterior circulation stroke, like clinical syndromes, underlying risk factors, ethnic and genetic particularities, etiologies, diagnosis, acute therapy, and outcomes. For example, while mechanical thrombectomy in large vessel occlusions in the anterior circulation has become the new gold standard in acute recanalization therapy, its efficacy and safety in acute basilar occlusion is still under debate despite the recent completion of two randomized controlled trials (BEST and BASICS). Furthermore, while perfusion imaging can help the selection of patients for recanalization therapies in the anterior circulation, its role and relevance in posterior circulation stroke is less well described. We aim to elucidate characteristics of posterior circulation ischemia in its presentation, diagnosis, and treatment, and search for high quality studies on the topics listed below and beyond.

We call upon this Research Topic, hoping to improve our understanding of posterior circulation ischemic stroke and aim to explore novel treatment strategies. Manuscripts with the following themes are especially welcome:
- Acute basilar artery occlusion
- Cerebellar ischemic stroke
- Imaging of posterior circulation ischemic stroke
- Risk factors, etiology, and genetics of posterior circulation ischemic stroke
- Acute (endovascular) treatment of posterior circulation ischemic stroke
- Outcome after posterior circulation ischemic stroke
- Mimics of posterior circulation ischemic stroke
- Medical and interventional secondary prevention therapy for posterior circulation stroke

The editors would like to receive clinical or translational research, in the form of Original Research, Commentaries, Opinions, interesting Case Reports, or Reviews.

The Topic Editors, Dr. Thanh Nguyen received research support from Medtronic, and Dr. Simon Nagel received research support from Cerenovus. The other Topic Editors declare no competing interests with regard to the Research Topic subject.


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Posterior circulation ischemic stroke comprises around 15-20% of all ischemic strokes. An acute occlusion of the basilar artery triggers the most devastating ischemic stroke syndrome with altered consciousness, loss of brainstem reflexes, and tetraplegia. However, posterior circulation stroke is often hard to diagnose clinically as well as radiologically if magnetic resonance imaging is not available. The anatomy of the posterior circulation is highly variable and stroke syndromes within have distinct etiologies, risk factors, and ethnic distribution that might vary from the anterior circulation. Acute recanalization therapies, like intravenous thrombolysis and mechanical thrombectomy, have been studied less in patients with posterior circulation stroke and the outcome of patients tends to be worse than that of patients with anterior circulation stroke.

Acute posterior circulation ischemic stroke varies from anterior circulation stroke in many ways. The goal of this Research Topic is to cover all aspects of acute posterior circulation stroke, like clinical syndromes, underlying risk factors, ethnic and genetic particularities, etiologies, diagnosis, acute therapy, and outcomes. For example, while mechanical thrombectomy in large vessel occlusions in the anterior circulation has become the new gold standard in acute recanalization therapy, its efficacy and safety in acute basilar occlusion is still under debate despite the recent completion of two randomized controlled trials (BEST and BASICS). Furthermore, while perfusion imaging can help the selection of patients for recanalization therapies in the anterior circulation, its role and relevance in posterior circulation stroke is less well described. We aim to elucidate characteristics of posterior circulation ischemia in its presentation, diagnosis, and treatment, and search for high quality studies on the topics listed below and beyond.

We call upon this Research Topic, hoping to improve our understanding of posterior circulation ischemic stroke and aim to explore novel treatment strategies. Manuscripts with the following themes are especially welcome:
- Acute basilar artery occlusion
- Cerebellar ischemic stroke
- Imaging of posterior circulation ischemic stroke
- Risk factors, etiology, and genetics of posterior circulation ischemic stroke
- Acute (endovascular) treatment of posterior circulation ischemic stroke
- Outcome after posterior circulation ischemic stroke
- Mimics of posterior circulation ischemic stroke
- Medical and interventional secondary prevention therapy for posterior circulation stroke

The editors would like to receive clinical or translational research, in the form of Original Research, Commentaries, Opinions, interesting Case Reports, or Reviews.

The Topic Editors, Dr. Thanh Nguyen received research support from Medtronic, and Dr. Simon Nagel received research support from Cerenovus. The other Topic Editors declare no competing interests with regard to the Research Topic subject.


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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Submission Deadlines

12 October 2020 Abstract
09 February 2021 Manuscript

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

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Topic Editors

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Submission Deadlines

12 October 2020 Abstract
09 February 2021 Manuscript

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

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