The Value Of Magnetic Resonance In The Paramedian Pontine Infarcts

[Objective]To analysis the clinical manifestations and MRI radiographic features of Parame- dian pontine infarcts. To explore the clinical value of the application of diffusion weighted imaging (DWI) and magnetic resonance angiography(MRA) on the manifestations, radiographic features, risk factors and the prognosis of PPI. So that it is help to evaluate the severity and prognosis of infarction and make the reasonable treatment.[Methods]Fourty-eight cases of PPI patients were involved in our study ,and the DWI and MRA were scaned in 24 to 48 hours to get the MR images of the patients. At the same time, the level of LDL-C, blood pressure, blood sugar, fiber fibrinogen and the results of cardiac color Doppler ultrasound were collected, as well as the history of smoking, drinking, TIA attack or acardio-cerebral vascular events were asked. All the cases were evaluated using neurological deficit score (NIHSS points) to get the neurological deficits ,and using the mRS Rating to judge the prognosis in 90 days.[Results]1. Paramedian pontine infarct is one of most common infarcts in the posterior circulatory system(28.3%). MR showed edge-shaped lesions in the pons extending to the paramedian pontine, while MRA showed basilar artery was normal or irregular stenosis (79.2%).2.The risk factors included diabetes mellitus (35.4%), lipid metabolic disorders (31.2%) except hypertension (64.5%), but no correlation was found in atrial fibrillation (P <0.05)3.The main clinical features were hemi-paresis(76.1%), accompanied by dysarthria (91.6%), vertigo (79.2%), ataxi (52.1%) and hemiparethesia( 35.4%) and so on. The neurological deficits in the lower part lesion were more serious than they were in the upper part lesion (P <0.05).4 . Most of the PPI cases'mRS Rating in 90 days were below the third level(91.7%) , which showed a light- moderate degree.[Conclusions]The Paramedian pontine infarcts are more common than we have known. The cause of disease was the clogging atherosclerotic plaque of the branch artery. The neurological deficits in the lower part lesion of PPI are more serious than they were in the upper part lesion. The remaining living ability and dependence is light -moderate degree.