| r Objective]Comparative analysis for the clinical、radiographic features、early progressive motor deficits and short-term prognosis between paramedian pontine infarctions and lacunar pontine infarctions, and clinical use of magnetic resonance plaque imaging for basilar artery.[Methods]A consecutive series of86patients with acute isolated pontine infarction, who had diffusion weighted imaging (DWI) and magnetic resonance angiography (MRA) within72hours of onset were enrolled in this study, in which10cases of PPI completed high-resolution magnetic resonance plaque imaging of basilar artery.①They were divided into two groups based on the maximal diameters and location of infarctions:paramedian pontine infarction, PPI (n=35, maximal diameters>15mm, infarction extending to the pontine surface) and pontine lacunar infarction, LPI (n=51, maximal diameters<15mm, infarction within pons).②According to the early progressive motor deficits (PMD), they were divided into two groups:PMD(n=22) and without PMD(n=64).③According to the scores of modified Rankin Scale (mRS) at1month, they were divided into two groups:worse prognosis (n=35) and good prognosis (n=51). Comparative analysis for the clinical features and the factors associated.[Results]1.Comparison between PPI and LPI. The proportion of patients with hyperlipidemia in PPI group [20/35(57.14%)] was significantly higher than that in LPI group [17/51(33.33%), x2=4.800, P=0.028]; The initial National Institutes of Health Stroke Scale (NIHSS) in PPI group showed significantly higher than that in LPI group(6.00±2.39vs4.61±3.41,t=2.087, P=0.040); The proportion of patients with hemiplegia in PPI group [34/35(97.14%)] was significantly higher than that in LPI group [37/51(72.55%), x2=8.718, P=0.003]; The proportion of patients with basilar artery stenosis [16/35(45.71%)] was significantly higher than that in LPI group [9/51(17.65%),x2=7.930, P=0.005]; The proportion of patients with mRS>2was significantly higher in PPI group [19/35(54.29%)] than that in LPI group [16/51(31.37%), x2;=4.515, P=0.034].2. Comparison between the patients with PMD and without PMD. Diastolic blood pressure of patients with PMD was significantly higher than that without PMD(97.82±15.61vs89.55±12.23,t=2.258, P=0.031); The proportion of PPI with PMD [14/22(63.64%)] was significantly higher than that without PMD [21/64(32.81%), x2=6.445, P=0.011]. The proportion of basilar artery stenosis with PMD [13/22(59.10%)] was significantly higher than that without PMD [12/64(18.75%), x2=12.922, P=0.000],3. Comparison between the patients with worse prognosis and good prognosis. The initial NIHSS and fasting blood glucose in the patients with worse prognosis were significantly higher than that in the patients with good prognosis (6.80±2.63vs3.73±2.55,t=5.426, P=0.000;9.40±5.15vs6.56±2.69,t=2.985, P=0.004). The proportion of PPI[19/35(54.29%)] was significantly higher than that of LPI in the patients with worse prognosis [16/51(31.37%), x2=4.515, P=0.034]. The Logistic regression analysis showed that basilar artery stenosis was positively related to PPI(OR=3.801,95%CI1.357-10.646, P=0.011); Basilar artery stenosis was independently related to early PMD(OR=4.571,95%CI1.214-17.214, P=0.025); The initial NIHSS>5was independently related to a worse prognosis (OR=4.277,95%CI1.505-12.151, P=0.006)4.10cases of PPI completed high-resolution magnetic resonance plaque imaging of basilar artery, in which8cases had various sizes atherosclerotic plaques.[Conclusions]1. PPI is mostly related to pathologic changes in basilar artery branch.2. Patients with initial NIHSS>5in isolated pontine infarctions may be associated with a worse short-term prognosis.3. Patients with progressive isolated pontine infarction and a worse short-term prognosis are mostly caused by pathologic changes in basilar artery. |
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