Pontine Infarction: A Prospective Cohort Study on Its Clinical Features, Prognosis, and Association with Branch Atheromatous Disease

Abstract

BackgroundDespite existing research on brainstem infarction, there are limited evidence for pontine infarctions, which have been often associated with significant recurrence risks and variable outcomes. We aimed to analyze the characteristics, prognosis, and rehabilitation outcomes of pontine infarctions, including branch atheromatous disease (BAD).MethodsWe analyzed 408 pontine stroke cases from the Baba Memorial Hospital (2012-2022), excluding irrelevant cases. We focused on variables, such as the age, sex, medical history, antithrombotic drug use, symptoms, BAD, and functional independence measure (FIM) scores at admission and discharge. The patients were categorized into good and poor prognosis groups based on their discharge FIM scores. Univariate and logistic regression analyses were performed with age adjustments because of their strong correlation. We performed a comparison between the patients with and without BAD, followed by multiple regression analysis using FIM efficiency.ResultWe evaluated the rehabilitation outcomes in patients with pontine infarction using the FIM. We recorded a 63% rate of home discharge, similar to that of other stroke types. Patients with an admission FIM score ≥63 were more likely to be discharged regardless of their age. Factors, such as the age, paralytic symptoms, and stroke history determined the rehabilitation efficiency and discharge outcomes significantly(p<0.05). BAD did not impact prognosis significantly, despite its association with lower admission FIM scores caused by dysarthria and paralysis. Notably, a history of smoking and stroke was associated with lower FIM scores, indicating diminished rehabilitation effectiveness. Conversely, patients with dyslipidemia exhibited improved rehabilitation outcomes.ConclusionsThis study demonstrated a 63% home discharge rate for patients who have had pontine stroke, akin to others. Elevated admission FIM scores enhance the likelihood of discharge, whereas smoking and previous strokes impede rehabilitation, highlighting the need for specialized treatment approaches and additional studies.