| Objective: Operated MRI examination for 179 cases of pontine infarction patients,The pons was divided into upper,middle and lower segment combined with vascular anatomy distribution,we analysis clinical signs for each region and explore the lesions high-risk areas related risk factors and pathogenesis.Methods:The clinical characteristics and iconography in 179 cases of the pons infarction patients were analysised retrospectively from January 2013 to December2015 in The Second Hospital Affiliated to Dalian Medical University.All patients in our hospital were given the detection of MRI and MRA/CTA,blood biochemistry and routine practice,etc.The pons was divided into upper,middle and lower segment.We have observed the different segments of pontine infraction lesion distribution characteristics combined with the corresponding relationship of vascular(paracentral artery,short spiral artery,long spiral artery)distribution to further analysis its clinical characteristics,At the same time,the high incidence of lesions were grouped,and the related risk factors were analyzed.Results:(1)The pons was divided into upper,middle and lower segment,Most cases were middle infraction(47 cases,26.3%),the second was the inferior pons(36 cases,20.1%)in 36 cases(20.1%),and then the upper in(28 cases,15.6%).31 cases(17.3%)involved the upper and middle,the middle and lower section,the upper and lower section or three-section at the same time,in which middle and lower segment patients were most.(2)According to the distribution of vessesls,The pons would be divided into the paracentral artery(anterior medial area),short spiral artery(anterolateral area),long spiral artery(lateral area).Most of 179 cases of pons infarction patients involved the anterior medial area accounts for 86 cases(48.0%),the lagest propotion,hemiplegia patients,a total of 63 cases(73.3%),central facial paralysis in 46 cases(53.4%),lallation in 41 cases(47.7%),and sensory disturbance in 12 cases(14.0%).involved the short spiral artery holds 24 patients(13.4%),involved with disorder of feelingaccounted for up to a total of 17(70.8%),dysarthria in 11 cases(45.8%),central facial paralysis and(or)tongue collapsed in 10 cases(41.7%).Invoving the lateral region of14 cases,10 cases of vertigo symptoms(Lesions located in the middle and lower section of pons),8 cases of merger hemiplegia,6 cases of merging partial body feels obstacle.At the same time,involving the anterior medial area or lateral,anterolateral area in 55cases(30.7%).(3)The high incidence of pontine lesion which was divided into three groups: the upper,lower and midpons and under three groups of patients with single factor analysis of gender,age,blood glucose,atherosclerosis,hypertension,smoking differences had no statistical significance(P>0.05).However,there are significant differences in stenosis,blood glucose and blood lipid differences(P<0.05).Multivariate logistic regression analysis showed that blood fat was independent risk factors(P<0.05).(4)In the middle part of the pons disease high blood lipids,vascular stenosis patients were 24 cases,22cases.Followed by the inferior pons were 6cases,5cases.The upper pons were 6 cases,5cases.Conclusion:(1)The anteromedial of pons is the most common sites for pons infarction which also called paracentral artery blood supply zone and the section of the high incidence is the middle and lower,which is associated with vascular anatomy.(2)The pons infarction at different positions of the anteromedial area associated with lipid,prompt paramedical pontine infarction may be caused by atherosclerosis.(3)The clinical manifestations in patients with pontine infarction is similar to supratentorial lesions,missed diagnosis with clinical misdiagnosis. |
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