| Background and objective: Pontine stroke is easy to be misdiagnosed andmissed diagnosed due to the special anatomical structure of pons, the rapid onset, thecritical condition, the poor prognosis and no imaging support. Our study aimed toretrospectively analyze the clinical manifestation and the imaging result of pontinestroke in order to further understand its clinical and imaging characteristics and todeepen our knowledge of pontine stroke.Method: The clinical data of111patients with pontine stroke were retrospectivelyanalyzed.75cases (63.03%) were male and44cases (36.97%) were female. Amongthem,96cases (80.67%) had pontine infarction,22cases (18.49%) had pontinehemorrhage and1case (0.84%) had mixed stroke. Each ischemic lesion was confirmedby brain MRI and each hemorrhagic lesion was confirmed by brain CT. According todifferent anatomical levels, pons was divided into three anatomical planes—the uppersegment, the middle segment, and the bottom segment; and each plane was divided indetails into5locations on axial plane: ventral lateral, ventral medial, dorsal lateral,dorsal medial and centre. The number, location, shape, and distribution of lesions aswell as the amount of bleeding were recorded in each case. The clinical symptoms andsigns of each case were summarized. The relationship of stroke location, clinicalsymptoms and signs, and pontine syndrome was analyzed in details. And the clinicalmanifestations and imaging characteristics were explored.Result:①The initial clinical manifestations were complex and diverse. Thefollowing symptoms were most common among the patients: limb paralysis was foundin94(78.99％) cases, central facial palsy was found in68(57.14％) cases, sensorydisturbance was found in39(32.77%) cases, barylalia was found in61(51.26％) cases,central tongue palsy was found in32(26.89％) cases and vertigo was found in 29(24.37%)cases.②In the group,85cases (71.42%) had hypertension,81cases(68.06%) had atherosclerosis,49cases (41.17%) had hyperlipemia, and39cases(32.77%) had diabetes.③Among the119patients with pontine stroke, lesions werefound in the upper segment of pons in27cases (22.69%), in the middle segment ofpond in75cases(63.03%), and in the bottom segment of pons in17cases (14.29%);lesions were found in the ventral medial in51cases(42.86%), in the ventral lateral in27cases(22.69%), in the dorsal medial in14cases(11.76%), in the dorsal lateral in7cases (5.88%), and in the centre in20cases(16.81%).④In the view of the nature ofstroke,96cases had pontine infarction,22cases had pontine hemorrhage and1case hadmixed stroke.⑤Most of the patients in the group had contralateral central facial and/ortongue palsy, combined with limb paralysis with or without sensory disturbance, andonly8cases had classical pontine syndrome with one-and-a-half syndrome in5cases,Millard-Gubler syndrome in2cases, and locked-in syndrome in1case.Conclusion:①Pontine stroke is most common in males.②hypertension，Atherosclerosis, Hyperlipidemia and Diabetes are the most important risk factors ofpontine stroke. Cross symptoms or signs are not common in pontine stroke patients, andclassical pontine syndrome cases are rare.③As for the stroke location, it is mostcommon in the middle segment of pons, mainly in ventral medial side; as for the natureof stroke, ischemic stroke is most common.④The most common clinical manifestationsof pontine stroke are limb paralysis, central facial palsy, sensory disturbance, barylaliaand central tongue palsy.⑤Brain CT and/or MRI examinations play a significant rolein the diagnosis of pontine stroke. |
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