SYNDROMES OF PONTINE BASE INFARCTION - A CLINICAL-RADIOLOGICAL CORRELATION STUDY

被引:81
作者
KIM, JS
LEE, JH
IM, JH
LEE, MC
机构
[1] Department of Neurology, University of Ulsan, Asan Medical Center, Seoul
关键词
CEREBRAL INFARCTION; DIAGNOSTIC IMAGING; LACUNAR INFARCTION; PONS;
D O I
10.1161/01.STR.26.6.950
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose Although there have been sporadic reports of lacunar syndromes due to pontine base infarction, studies of clinical-radiological correlation in sufficient numbers of patients have not yet been reported. Methods We studied the clinical features of 37 patients with acute infarcts that mainly involved the base of the pens and correlated the clinical syndromes with the radiological findings. Results The clinical presentations included pure motor hemiparesis (PMH) in 17, sensorimotor stroke in 3, ataxic hemiparesis (AH) in 4, and dysarthria-clumsy hand (DA-CH) syndrome in 6 patients. Variants of AH included 1 patient with dysarthria-hemiataxia and 2 with quadrataxic hemiparesis, and in 4 patients dysarthria-facial paresis syndrome was considered a variant of DA-CH syndrome. Hypertension was the single most common and important risk factor, and the pathogenetic mechanisms of ischemia were likely to be small arterial (lacunar) occlusion or basilar atheromatous branch occlusion in most of the patients. Our clinical-radiological correlation study suggested that large lesions involving the paramedian caudal or middle pens correlate with severe hemiparesis (PMH), whereas lesions of similar size located in the paramedian rostral pens tended to produce DA-CH syndrome. Lesions producing AH were located variously but tended to spare the pyramidal tracts. The prognosis of these patients is fair or good, although residual hemiparesis remained in patients with initially severe hemiparesis. Conclusions Our data suggest that the various lacunar syndromes that follow pontine base infarcts reflect the balance of the involvement of the corticospinal, corticopontocerebellar, and corticobulbar tracts. Analysis of radiological findings aids in determining the clinical-anatomic correlation in patients with pontine base infarction.
引用
收藏
页码:950 / 955
页数:6
相关论文
共 69 条
  • [1] PATHOANATOMIC CORRELATION BETWEEN POSTSTROKE PATHOLOGICAL CRYING AND DAMAGE TO BRAIN-AREAS INVOLVED IN SEROTONERGIC NEUROTRANSMISSION
    ANDERSEN, G
    INGEMANNIELSEN, M
    VESTERGAARD, K
    RIIS, JO
    [J]. STROKE, 1994, 25 (05) : 1050 - 1052
  • [2] EFFECTIVE TREATMENT OF POSTSTROKE DEPRESSION WITH THE SELECTIVE SEROTONIN REUPTAKE INHIBITOR CITALOPRAM
    ANDERSEN, G
    VESTERGAARD, K
    LAURITZEN, L
    [J]. STROKE, 1994, 25 (06) : 1099 - 1104
  • [3] ISOLATED DYSARTHRIA
    ARBOIX, A
    MASSONS, J
    OLIVERES, M
    TITUS, F
    [J]. STROKE, 1991, 22 (04) : 531 - 532
  • [4] BASSETTI C, 1993, NEUROLOGY, V43, P159
  • [5] BILLER J, 1986, J COMPUT ASSIST TOMO, V10, P379
  • [6] EARLY DIAGNOSIS OF BASILAR ARTERY-OCCLUSION USING MAGNETIC-RESONANCE IMAGING
    BILLER, J
    YUH, WTC
    MITCHELL, GW
    BRUNO, A
    ADAMS, HP
    [J]. STROKE, 1988, 19 (03) : 297 - 306
  • [7] THE ETIOLOGY OF POSTERIOR CIRCULATION INFARCTS - A PROSPECTIVE-STUDY USING MAGNETIC-RESONANCE-IMAGING AND MAGNETIC-RESONANCE ANGIOGRAPHY
    BOGOUSSLAVSKY, J
    REGLI, F
    MAEDER, P
    MEULI, R
    NADER, J
    [J]. NEUROLOGY, 1993, 43 (08) : 1528 - 1533
  • [8] CLINICO-TOPOGRAPHIC CORRELATION OF SMALL VERTEBROBASILAR INFARCT USING MAGNETIC-RESONANCE-IMAGING
    BOGOUSSLAVSKY, J
    FOX, AJ
    BARNETT, HJM
    HACHINSKI, VC
    VINITSKI, S
    CAREY, LS
    [J]. STROKE, 1986, 17 (05) : 929 - 938
  • [9] CAPSULAR GENU SYNDROME
    BOGOUSSLAVSKY, J
    REGLI, F
    [J]. NEUROLOGY, 1990, 40 (10) : 1499 - 1502
  • [10] BOGOUSSLAVSKY J, 1994, NEUROLOGY, V44, P2023