Clinical and imaging characteristics of isolated pontine infarcts: a one-year follow-up study

Abstract

Objective: Although clinically relevant, there is paucity of literature regarding the characteristic findings and outcome in isolated pontine infarction (IPI). In this study, we examined and analyzed the association between neurological findings, imaging features, and outcomes at different time periods in patients with acute IPI.Methods: A total of 101 patients (32 women and 69 men) with IPI were included in this study. The data were prospectively collected within 7 days of stroke onset. A combination of diffusion-weighted imaging (DWI) and magnetic resonance angiography (MRA) was utilized for lesion analysis. Isolated pontine infarcts were categorized into three subtypes: large artery disease (LAD), basilar artery branch disease (BABD), and small artery disease (SAD). Patients were followed for 1 year to assess functional outcome and neurological deficit.Results: The most common type of IPI was BABD (53·5%). The baseline neurologic impairment was significantly more severe in the LAD and BABD groups than the SAD group (P = 0·002). Intracranial or extracranial arteriostenosis was dominated by LAD and was found in 44 patients (43·6%). Although 25·7% of patients had a poor outcome at 3 months post-stroke onset, their quality of life improved at the 1-year follow-up period.Discussion: Our study also provided the evidence that unilateral pontine infarction from BABD is the most prevalent subtype of IPI; the incidence of basilar artery stenosis was low; long-term prognosis was favorable.