Topographic location of unisolated pontine infarction

Huang, Jiehong; Qiu, Zhihua; Zhou, Piansi; Li, Jianming; Chen, Yingxin; Huang, Ruiyun; Li, Chujing; Ouyang, Xi‐Lin; Feng, Huazhuo; Xu, Huimin; Liu, Dezhi; Zheng, Dong; Zhu, Juehua; Liu, Xinfeng; Chen, Hongbing; Jiang, Yanrui

doi:10.1186/s12883-019-1411-6

Cited by 15 publications

(22 citation statements)

References 18 publications

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“…Anteromedial infarction causes hemiparesis or hemiplegia, contralateral ataxia, dysarthria, nystagmus, and often ipsilateral facial palsy. The anteromedial pons harbors the descending motor fibers, the nuclei of the 6th and 7th cranial nerves, and the pontocerebellar fibers [1, 7].…”

Section: Discussionmentioning

confidence: 99%

“…These clinical features were fairly consistent with lesions involving the neural structures located in the anteromedial pontine section. The absence of contralateral sensory dysfunctions and auditory dysfunction may be explained by the relatively lateral location of spinothalamic fibers and vestibulocochlear nuclei, respectively [1,3,[7][8][9].…”

Section: Pontine Vascular Territory and Neuroanatomic Correlatesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Pontine infarction accounts for 7% of all ischemic strokes and 20% of brain stem strokes [1]. Pontine infarctions can be isolated or not isolated if they present in other parts of the brain [1]. Caudal pontine syndrome can have two patterns of presentation based on the segment of penetrating paramedian vessel affection: proximal and distal occlusion [2].…”

Section: Introductionmentioning

confidence: 99%

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Millard-Gubler Syndrome Associated with Cerebellar Ataxia in a Patient with Isolated Paramedian Pontine Infarction – A Rarely Observed Combination with a Benign Prognosis: A Case Report

Ayele

Tadesse

Guta³

et al. 2021

Case Rep Neurol

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Isolated pontine infarction accounts for 7% of all ischemic strokes. Millard-Gubler syndrome is a clinical syndrome which occurs following lesions involving the ventral portion of the caudal pons, resulting in classic clinical features such as ipsilateral abducens and facial nerve palsy and contralateral hemiparesis. We report the case of a 55-year-old male patient having presented to the Yehuleshet Specialty Clinic 6 years back with sudden-onset dysarthria and appendicular ataxia of 10 days duration. He reported having right hemibody weakness and blurred vision, which have significantly improved since then. He had a history of smoking of 30 pack-years. However, he quit smoking 8 years ago. There was no history of prior stroke, transient ischemic attack, diabetes, hypertension, head trauma, or dyslipidemia. On examination, he had horizontal left gaze palsy with horizontal nystagmus suggesting left-sided 6th cranial nerve palsy. He had mild left-sided facial palsy causing dysarthric speech. Right upper limb dysmetria was observed during examination; otherwise, motor, sensory, fundus, and gait examination results were normal. He had low serum vitamin D. Brain magnetic resonance imaging examination showed a 25 × 10 mm segmental lesion in the left median pons involving the basis pontis and tegmentum section. The lesion had T2 and T1 abnormal prolongation with no diffusion restriction, suggesting a subacute pontine infarct. The patient was managed with aspirin 325 mg, atorvastatin 80 mg, physical therapy, and vitamin D supplementation, and advised on behavioral risk factors. Six years after his isolated pontine infarction, the patient is fully recovered from dysarthria, facial palsy, hemiparesis, right-sided appendicular ataxia, and horizontal nystagmus, and the follow-up brain MRI showed radiological evidence of chronic paramedian pontine perforator infarction. Millard-Gubler syndrome may present with cerebellar ataxia if the paramedian pontine infarction area slightly extends laterally, affecting the middle cerebellar peduncles. Isolated pontine infarction may have a good prognosis if diagnosed and managed early.

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Section: Discussionmentioning

confidence: 99%

Section: Pontine Vascular Territory and Neuroanatomic Correlatesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Millard-Gubler Syndrome Associated with Cerebellar Ataxia in a Patient with Isolated Paramedian Pontine Infarction – A Rarely Observed Combination with a Benign Prognosis: A Case Report

Ayele

Tadesse

Guta³

et al. 2021

Case Rep Neurol

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“…This study had some limitations. First, due to the strict inclusion criteria, the sample size was relatively small, and some studies have suggested that the clinical manifestation and prognosis vary according to the level of PI (Jang, 2012;Huang et al, 2019). In addition, the small sample size also limited the statistical power.…”

Section: Longitudinal Fc Changes In the Lpi And Rpi Groupsmentioning

confidence: 99%

Disrupted Regional Cerebral Blood Flow and Functional Connectivity in Pontine Infarction: A Longitudinal MRI Study

Wei

Wang

et al. 2020

Front. Aging Neurosci.

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Abnormal cerebral blood flow (CBF) and resting-state functional connectivity (rs-FC) are sensitive biomarkers of disease progression and prognosis. This study investigated neural underpinnings of motor and cognitive recovery by longitudinally studying the changes of CBF and FC in pontine infarction (PI). Twenty patients underwent three-dimensional pseudo-continuous arterial spin labeling (3D-pcASL), resting-state functional magnetic resonance imaging (rs-fMRI) scans, and behavioral assessments at 1 week, 1, 3, and 6 months after stroke. Twenty normal control (NC) subjects underwent the same examination once. First, we investigated CBF changes in the acute stage, and longitudinal changes from 1 week to 6 months after PI. Brain regions with longitudinal CBF changes were then used as seeds to investigate longitudinal FC alterations during the follow-up period. Compared with NC, patients in the left PI (LPI) and right PI (RPI) groups showed significant CBF alterations in the bilateral cerebellum and some supratentorial brain regions at the baseline stage. Longitudinal analysis revealed that altered CBF values in the right supramarginal (SMG_R) for the LPI group, while the RPI group showed significantly dynamic changes of CBF in the left calcarine sulcus (CAL_L), middle occipital gyrus (MOG_L), and right supplementary motor area (SMA_R). Using the SMG_R as the seed in the LPI group, FC changes were found in the MOG_L, middle temporal gyrus (MTG_L), and prefrontal lobe (IFG_L). Correlation analysis showed that longitudinal CBF changes in the SMG_R and FC values between the SMG_R and MOG_L were associated with motor and memory scores in the LPI group, and longitudinal CBF changes in the CAL_L and SMA_R were related to memory and motor recovery in the RPI group. These longitudinal CBF and accompany FC alterations may provide insights into the neural mechanism underlying functional recovery after PI, including that of motor and cognitive functions.

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Effect of mean platelet volume and platelet count on the prognosis of branch atheromatous disease

Liu,

Wu,

et al. 2024

Brain and Behavior

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ObjectiveThe purpose of this study was to investigate the predictive value of mean platelet volume (MPV) and platelet count (PC) in branch atheromatous disease (BAD).MethodsThis retrospective study included 216 patients with BAD‐stroke within 48 h of symptom onset. These patients were divided into good and poor prognosis groups according to their 3‐month modified Rankin scale scores after discharge. Multiple logistic regression analysis was used to evaluate independent predictors of poor prognosis in BAD‐stroke patients. Receiver‐operating characteristic (ROC) analysis was used to estimate the predictive value of MPV and PC on BAD‐stroke.ResultsOur research showed that a higher MPV (aOR, 2.926; 95% CI, 2.040–4.196; p < .001) and PC (aOR, 1.013; 95% CI, 1.005–1.020; p = .001) were independently associated with poor prognosis after adjustment for confounders. The ROC analysis of MPV for predicting poor prognosis showed that the sensitivity and specificity were 74% and 84.9%, respectively, and that the AUC was .843 (95% CI, .776–.909, p < .001). The optimal cut‐off value was 12.35. The incidence of early neurological deterioration (END) was 24.5% (53 of 163), and 66% of patients in the poor prognosis group had END (33 of 50). Multiple logistic regression analyses showed that elevated MPV and PC were associated with the occurrence of END (p < .05).ConclusionOur results suggested that an elevated MPV and PC may be important in predicting a worse outcome in BAD‐stroke patients. Our study also demonstrated an independent association of MPV and PC with END, which is presumably the main reason for the poor prognosis.

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Topographic location of unisolated pontine infarction

Cited by 15 publications

References 18 publications

Millard-Gubler Syndrome Associated with Cerebellar Ataxia in a Patient with Isolated Paramedian Pontine Infarction – A Rarely Observed Combination with a Benign Prognosis: A Case Report

Millard-Gubler Syndrome Associated with Cerebellar Ataxia in a Patient with Isolated Paramedian Pontine Infarction – A Rarely Observed Combination with a Benign Prognosis: A Case Report

Disrupted Regional Cerebral Blood Flow and Functional Connectivity in Pontine Infarction: A Longitudinal MRI Study

Effect of mean platelet volume and platelet count on the prognosis of branch atheromatous disease

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