Among patients with acute posterior circulation infarction, fetal-type posterior cerebral artery (FTP) was independently associated with greater admission NIHSS-defined stroke severity, with an adjusted OR of 5.604 (95% CI: 2.519–12.465).
Fetal-type posterior cerebral artery (FTP) was independently associated with moderate-to-severe stroke in acute posterior circulation infarction after multivariable adjustment.
NIHSS scores were significantly higher in FTP patients compared to non-FTP patients.
Univariate analysis identified significant differences in fasting blood glucose between mild and moderate-to-severe stroke groups.
Univariate analysis identified significant differences in uric acid levels between mild and moderate-to-severe stroke groups.
Univariate analysis identified a significant difference in the prevalence of FTP between mild and moderate-to-severe stroke groups.
The study cohort consisted of 161 patients with acute posterior circulation infarction diagnosed by cranial MRI.
The authors note several limitations requiring cautious interpretation of the FTP-severity association.
This research investigated what factors are associated with how severe a stroke is when it occurs in the back part of the brain (called the posterior circulation), which controls functions like balance, vision, and coordination. The study looked at 161 patients and found that a particular variation in brain blood vessel anatomy—called a fetal-type posterior cerebral artery (FTP)—was strongly linked to more severe strokes as measured by a standard clinical scale (the NIHSS). Patients with this anatomical variant had average stroke severity scores nearly 3.5 points higher than those without it. The FTP variant occurs when the posterior cerebral artery (which supplies blood to the back of the brain) originates primarily from the carotid artery in the neck rather than from the basilar artery at the base of the brain. This study suggests that when a stroke occurs in the posterior circulation, patients who have this anatomical variant may experience more severe neurological deficits at hospital admission. Higher fasting blood glucose and higher uric acid levels were also associated with greater stroke severity in initial analyses, though only FTP remained independently significant after accounting for other factors. This research suggests that FTP may be a useful imaging marker that doctors can identify on routine MRI/MRA scans to help anticipate stroke severity in patients with posterior circulation strokes. However, because this was a retrospective study from only two hospitals and had some measurement limitations, the authors caution that these findings need to be confirmed in larger, prospective studies before clinical applications can be established.
He J, Hao T, Li W, Liu Y, Liu Y, Zhou X. (2026). Association between fetal-type posterior cerebral artery variants and NIHSS-defined stroke severity in acute posterior circulation infarction.. Frontiers in neurology. https://doi.org/10.3389/fneur.2026.1728595