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. 2009 Jun 15:9:25.
doi: 10.1186/1471-2377-9-25.

Pontine infarction with pure motor hemiparesis or hemiplegia: a prospective study

Li Ling  1 , Liangfu Zhu, Jinsheng Zeng, Songjie Liao, Suping Zhang, Jian Yu, Zhiyun Yang
Affiliations

Pontine infarction with pure motor hemiparesis or hemiplegia: a prospective study

Li Ling et al. BMC Neurol. .

Abstract

Background: The study aimed to prospectively observe the clinical and neuroimaging features of pontine infarction with pure motor hemiparesis (PMH) or hemiplegia at early stage.

Methods: In 118 consecutive selected patients with the first-ever ischemic stroke within 6 hours after onset, fifty of them presented with PMH or hemiplegia and had negative acute computed tomography (CT) scans, then magnetic resonance imaging (MRI) confirmed the corresponding infarcts in pons or cerebrum. The clinical and neuroimaging features of the pontine infarctions were compared with those of cerebral infarctions.

Results: The pontine infarction with PMH or hemiplegia accounted for 10.2% (12/118) of all first-ever ischemic stroke patients and 24% (12/50) of the patients with both PMH or hemiplegia and acute negative CT scans. Compared to the patients with cerebral infarction, the patients with pontine infarction had more frequency of diabetes mellitus (50.0% vs 5.3%, P = 0.001), nonvertiginous dizziness at onset (58.3% vs 21.1%, P = 0.036) and a progressive course (33.3% vs 2.6%, P = 0.011).

Conclusion: The pontine infarction may present as PMH or hemiplegia with more frequency of nonvertiginous dizziness, a progressive course and diabetes mellitus. MRI can confirm the infarct location in the basal pons at early stage after stroke onset.

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Figures

Figure 1
Figure 1
Transversal T2 weighted imagings of magnetic resonance (MR) shows the infarction located in the dorsal surface of the pons, with the longitudinal strip or patch in shape (arrows show). The arabic numbers in brackets are patients' numbers.
Figure 2
Figure 2
Transversal T2 weighted imagings (a, b) and coronal FLAIR sequence (c, d) of MR show the infarction in the pons extending to the midbrain in case 1 (arrows show).
Figure 3
Figure 3
Transversal T2 weighted imagings of MR (a-d) show the infarction in the pons expanding to the level of the pontomedullary junction in case 6 (arrows show).
See this image and copyright information in PMC

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