ABSTRACT NUMBER: ESOC2026A2102 ANTERIOR VS POSTERIOR CIRCULATION INFARCTS: A RETROSPECTIVE STUDY IN YOUNG ADULTS WITH ISCHAEMIC STROKES

Abstract Background and aims Anterior circulation infarcts (ACI) account for around 75% of ischaemic strokes, whereas posterior circulation infarcts (PCI) comprise the remaining 25%. Comparative data on risk factors and functional outcomes remains limited, particularly in young adults. Methods We retrospectively analysed electronic patient records of adults ≤ 55 admitted to a hyperacute stroke unit between January 2024-June 2025. Haemorrhages, multiregional/embolic infarcts and patients with previous stroke history were excluded. Electronic patient records were analysed for demographics, NIHSS, risk factors and outcomes. Results 49.1% (147/299) of young adults admitted in this timeframe were included, of which 66.0% had anterior circulation infarcts (ACI) and 34.0% had posterior circulation infarcts (PCI). Mean age for both groups was 46.8. Males had a higher median NIHSS than females in both groups. There was a statistically significant difference in mean NIHSS (p<0.01) (6.77 in ACI and 4.26 in PCI) using Welch’s t-test. 30% of PCI was associated with diabetes compared to 15.4% of ACI. Atrial fibrillation was noted in 4.12% of ACI, and in no PCI. 15.5% of ACI had thrombolysis compared to 12.0% of PCI. 6.19% of ACI had thrombectomy compared to 2.0% of PCI. Haemorrhagic transformation occurred in 4.12% of ACI and did not occur in PCI. Conclusions There is a significant difference in NIHSS between the groups, possibly contributing to delayed diagnosis and intervention in PCI. The higher prevalence of diabetes in PCI demonstrates the need for tailored secondary prevention, highlighting the heterogeneity of stroke in young adults. Conflict of interest Arunan Varatharsan: Nothing to disclose Duaa Ali Faruqi: nothing to disclose. Teswahen Bedawi: nothing to disclose. Lakshmi Biju: nothing to disclose Aravinth Sivagnanaratnam: Nothing to disclose