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Progressive deficit in isolated pontine infarction: the association with etiological subtype, lesion topography and outcome

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Abstract

It is important to predict progressive deficit (PD) in isolated pontine infarction, a relatively common problem of clinical stroke practice. Traditionally, lacunar infarctions are known with their progressive course. However, few studies have analyzed the branch atheromatous disease subtype as a subtype of lacunar infarction, separately. There are also conflicting results regarding the relationship with the topography of lesion and PD. In this study, we classified etiological subtypes and lesion topography in isolated pontine infarction and aimed to investigate the association of etiological subtypes, lesion topography and clinical outcome with PD. We analyzed demographics, laboratory parameters, and risk factors of 120 patients having isolated pontine infarction and admitted within 24 h retrospectively. PD was defined as an increase in the National Institutes of Health Stroke scale ≥2 units in 5 days after onset. Patients were classified as following: large artery disease (LAA), basilar artery branch disease (BABD) and small vessel disease (SVD). Upper, middle and lower pontine infarcts were identified longitudinally. Functional outcome at 3 months was determined according to modified Rankin scores. Of 120 patients, 41.7% of the patients were classified as BABD, 30.8% as SVD and 27.5% as LAA. 23 patients (19.2%) exhibited PD. PD was significantly more frequent in patient with BABD (p 0.006). PD was numerically higher in patients with lower pontine infarction. PD was associated with BABD and poor functional outcome. It is important to discriminate the BABD neuroradiologically from other stroke subtypes to predict PD which is associated with poor functional outcome in patients with isolated pontine infarctions.

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Authors and Affiliations

  1. Bezmialem Vakif Universitesi Tip Fakultesi Hastanesi, Istanbul, Turkey

    Elif Gökçal, Elvin Niftaliyev, Çiğdem Deniz & Talip Asil

  2. Neurology Department, Şişli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey

    Gözde Baran

Authors
  1. Elif Gökçal
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  2. Elvin Niftaliyev
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  3. Gözde Baran
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  4. Çiğdem Deniz
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  5. Talip Asil
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Correspondence to Elif Gökçal.

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There was no funding for this study.

Conflict of interest

Author Elif Gökçal declares that she has no conflict of interest. Author Elvin Niftaliyev declares that he has no conflict of interest. Author Gözde Bran declares that she has no conflict of interest. Author Çiğdem Deniz declares that she has no conflict of interest. Author Talip Asil declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The data was obtained from our hospital records retrospectively for the study.

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Gökçal, E., Niftaliyev, E., Baran, G. et al. Progressive deficit in isolated pontine infarction: the association with etiological subtype, lesion topography and outcome. Acta Neurol Belg 117, 649–654 (2017). https://doi.org/10.1007/s13760-017-0827-2

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  • DOI: https://doi.org/10.1007/s13760-017-0827-2

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