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pontine infarct

Zhi-Yong Zhang, Zhi-Qin Liu, Wei Qin, Ya-Wen Chen, Zun-Jing Liu
Background: Wallerian degeneration (WD) of bilateral middle cerebellar peduncles (MCPs) can occur following pontine infarction, but its characteristics have not yet been clarified because of the low incidence. Thus, the present study discussed the clinical and radiological features to improve the awareness of this disease. Methods: Clinical and radiological information from consecutive individuals diagnosed with WD of bilateral MCPs following pontine infarction in three hospitals over the past 4 years between October 2012 and October 2016 were retrospectively investigated and compared with a control group (patients with pontine infarction had no secondary WD)...
March 20, 2018: Chinese Medical Journal
Bum Joon Kim, Kyung Mi Lee, Hyun Young Kim, Young Seo Kim, Seong-Ho Koh, Sung Hyuk Heo, Dae-Il Chang
BACKGROUND AND PURPOSE: Subclinical atherosclerotic plaques are common in patients with pontine infarctions (PIs) but without basilar artery (BA) stenosis. We hypothesized that BA plaque locations may differ by PI type and vertical location as well as vertebrobasilar artery geometry. METHODS: Ninety-six patients with PI but without BA stenosis on magnetic resonance imaging (MRI) and magnetic resonance angiography were enrolled. PIs were classified by type (paramedian, deep, or lateral) and vertical location (rostral, middle, or caudal)...
January 2018: Journal of Stroke
Reza Mohammadian, Ali Tarighatnia, Mehran Naghibi, Evin Koleini, Nader D Nader
Cerebral ischemia because of vertebrobasilar insufficiency (VBI) rarely presents as an initial sign within the systemic lupus erythematosus (SLE) population, and there are very few case reports supporting this manifestation. This report details 3 different patients with SLE who experienced VBI as an initial manifestation. Patient 1 was a 24-year-old female who developed a bilateral pontine lesion as a consequence of basilar artery stenosis. Patient 2 was a 34-year-old male with an acute ischemic lesion on the right side of his cerebellum and pons because of significant stenosis in the distal segment of the right vertebral artery...
January 3, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Cheng Xia, Hui-Sheng Chen, Shi-Wen Wu, Wei-Hai Xu
BACKGROUND: In this retrospective study, we investigated the main pathogenesis of the two types of isolated pontine infarction: paramedian pontine infarcts (PPIs) and small deep pontine infarcts (SDPIs). METHODS: Acute ischemic stroke patients, comprising 117 PPI patients and 40 SDPI patients, were enrolled. High-resolution magnetic resonance imaging (HR-MRI) and routine MRI sequences were performed for each patient, and clinical data were collected. The following brain small vessel disease (SVD) features of the MRI scans were each rated (0 or 1) separately: asymptomatic lacunar infarcts, white matter lesions (WMLs), deep and infratentorial cerebral microbleeds (CMBs), and enlarged perivascular spaces in the basal ganglia...
December 12, 2017: BMC Neurology
Soichiro Abe, Shuhei Okazaki, Shuichi Tonomura, Kotaro Miyashita, Masafumi Ihara
A rare case of bilateral ventrolateral pontine infarction in a 70-year-old man who developed progressive dysarthria and bilateral sensory disturbance is reported with literature review. He had been diagnosed with hypertension, dyslipidemia, and impaired glucose tolerance 10 years earlier. Ten days before admission, he was aware of the difficulty in walking and speaking, which gradually worsened. On admission he showed bilateral thermal hypoalgesia of face and lower extremities, dysarthria, dysphagia, and ataxic gait...
December 27, 2017: Rinshō Shinkeigaku, Clinical Neurology
Toshiyuki Sakai, Masahide Kondo, Yosuke Kawana, Toshio Nakagawa, Hidekazu Tomimoto
We investigated the diffusion weighted magnetic resonance imaging (DWI) features of 76 very elderly patients aged 90 years or above with acute ischemic stroke. Stroke subtypes were classified into five types according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) and the Japanese Stroke Databank. The incidence rates of atherothrombotic brain infarction (ATBI), atherothrombotic brain embolism (ATBE), lacunar infarction (LI), cardiogenic brain embolism (CBE) and undetermined type of brain infarction (UTBI) were 2...
November 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
Tao Liu, Jianjun Li, Shixiong Huang, Changqinq Li, Zhongyan Zhao, Guoqiang Wen, Feng Chen
We used resting-state functional magnetic resonance imaging to investigate the global spontaneous neural activity involved in pathological laughing and crying after stroke. Twelve pathological laughing and crying patients with isolated pontine infarction were included, along with 12 age- and gender-matched acute isolated pontine infarction patients without pathological laughing and crying, and 12 age- and gender-matched healthy controls. We examined both the amplitude of low-frequency fluctuation and the regional homogeneity in order to comprehensively evaluate the intrinsic activity in patients with post-stroke pathological laughing and crying...
October 13, 2017: Oncotarget
Hou-Zhen Tuo, Ze-Long Tian, Yi-Nong Cui, Xiao-Yang Ma, Chun-Ling Xu, Hong-Yan Bi, Li-Yan Zhang, Yong-Bo Zhang, Wei-Dong Le, William Ondo
OBJECTIVE: Pontine infarction is a common type of stroke in the cerebral deep structures, resulting from occlusion of small penetrating arteries, may manifest as hemi-paralysis, hemi-sensory deficit, ataxia, vertigo, and bulbar dysfunction, but patients presenting with restless legs syndrome (RLS) are extremely rare. Herein, we reported five cases with RLS as a major manifestation of pontine infarction. METHODS: Five cases of pontine infarction related RLS were collected from July 2013 to February 2016...
September 2017: Chronic Diseases and Translational Medicine
Sang Hun Lee, Seung Chai Jung, Dong Wha Kang, Sun U Kwon, Jong S Kim
BACKGROUND: The stroke mechanism for anterolateral pontine infarction (ALPI) is poorly understood. We aimed to investigate the perforator arteries relevant to ALPI using high-resolution MRI (HR-MRI). METHODS: Of 62 patients with ALPI who were admitted to the Asan Medical Center, 13 patients agreed to participate in this study. We used HR-MRI with a 3-Tesla scanner and assessed the perforating branches directly connected with the infarcted area. RESULTS: Perforating arteries penetrating ALPI were identified in all 13 patients...
September 19, 2017: European Neurology
Roderick P P W M Maas, Aad Verrips
No abstract text is available yet for this article.
August 22, 2017: Neurology
Elif Gökçal, Elvin Niftaliyev, Gözde Baran, Çiğdem Deniz, Talip Asil
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...
September 2017: Acta Neurologica Belgica
Daniela Ceccarelli, David Hargroves, Ibrahim Balogun, Thomas Webb
A 47-year-old man with poorly controlled hypertension presented with headaches, right-sided weakness and dysarthria. CT and MRI scans of the brain showed widespread abnormalities including significant pontine oedema, basal ganglia and corona radiata infarctions and cerebellar white matter high signal. Imaging of the intracerebral vasculature also demonstrated wall irregularities. Initially a central nervous system inflammatory disorder was thought to be the most likely diagnosis, possibly acute demyelinating encephalomyelitis or cerebral vasculitis, and the patient was treated with high-dose intravenous steroids...
July 19, 2017: BMJ Case Reports
Shaoyang Sun, Yanqiang Wang, Yuge Wang, Xuejiao Men, Jian Bao, Xueqiang Hu, Zhengqi Lu
BACKGROUND: The pathogenesis and progression of branch atheromatous disease (BAD), which differs from lipohyalinotic degeneration (LD), remains controversial. Few studies have investigated the lipid indices and glycometabolism status factors for BAD in first-ever penetrating artery infarction (PAI). METHODS: We retrospectively examined acute stroke patients with PAI admitted within 3 days after stroke. All patients underwent diffusion weight magnetic resonance imaging (DWI) and magnetic resonance angiography (MRA) and/or computed tomography angiography (CTA)...
June 2017: Brain and Behavior
Jorge C Kattah, Ali S Saber Tehrani, Sigrun Roeber, Meena Gujrati, Sarah E Bach, David E Newman Toker, Ari M Blitz, Anja K E Horn
OBJECTIVE: To report an unusual lateral medullary stroke (LMS) associated with transient unidirectional horizontal, nystagmus, and decreased horizontal vestibulo-ocular reflex (h-VOR) gain that mimicked a peripheral vestibulopathy. MRI suggested involvement of caudal medial vestibular nucleus (MVN); however, the rapid resolution of the nystagmus and improved h-VOR gain favored transient ischemia without infarction. Decreased h-VOR gain is expected with peripheral vestibular lesions within the labyrinth or superior vestibular nerve; less frequently lateral pontine strokes involving the vestibular root entry, the vestibular fascicle, or neurons within the MVN may be responsible...
2017: Frontiers in Neurology
Brandon D Liebelt, Sean M Barber, Viren R Desai, Richard Harper, Jonathan Zhang, Rob Parrish, David S Baskin, Todd Trask, Gavin W Britz
OBJECTIVE: To investigate potential effect of sacrifice of the superior petrosal vein (SPV) on postoperative complications after microvascular decompression (MVD). METHODS: Retrospective review of 98 consecutive patients undergoing MVD of cranial nerve V was performed. Frequency of division of the SPV during surgery was recorded, and postoperative complications and imaging were recorded and analyzed. In patients with complications, the specific anatomic variation of the superior petrosal venous complex was noted...
August 2017: World Neurosurgery
Timolaos Rizos, Andreas J Bartsch, Timothy D Johnson, Felix Dittgen, Thomas E Nichols, Uwe Malzahn, Roland Veltkamp
OBJECTIVE: Atrial fibrillation (AF) is frequently detected after ischemic stroke for the first time, and brain regions involved in autonomic control have been suspected to trigger AF. We examined whether specific brain regions are associated with newly detected AF after ischemic stroke. METHODS: Patients with acute cerebral infarctions on diffusion-weighted magnetic resonance imaging were included in this lesion mapping study. Lesions were mapped and modeled voxelwise using Bayesian Spatial Generalised Linear Mixed Modeling to determine differences in infarct locations between stroke patients with new AF, without AF and with AF already known before the stroke...
2017: PloS One
Bonnie M Kaas, David S Zee, Amir Kheradmand, Daniel R Gold
INTRODUCTION: Pseudoabducens palsy refers to abduction paresis in the absence of a pontine or peripheral nerve process. This finding has been described with mesodiencephalic lesions, and likely has a common mechanism with thalamic esotropia. CASE REPORT: We describe the case of a 55-year-old man who presented with near-complete ophthalmoparesis, sparing only adduction of the left eye. Magnetic resonance imaging of the brain demonstrated midbrain infarction. CONCLUSIONS: Pseudoabducens palsy is likely underrecognized, but can be highly localizing when identified...
May 2017: Neurologist
Luis Cartier R, Jorge Guzmán S, Renzo Pasquali F
Eyelid retraction, has received limited attention and it has passively been interpreted as the result of an overactive levator palpebrae superioris muscle secondary to midbrain injury. However, eyelid retractions can occur in other neurological diseases, not directly related with the midbrain. We report three patients who developed eyelid retraction. One patient had a bilateral eyelid retraction, related with Creutzfeldt-Jakob disease (CJD). Another patient had a unilateral right eyelid retraction associated with a thalamic-mesencephalic infarct...
February 2017: Revista Médica de Chile
Majid Khan, Sadaf Naveed, Iqbal Haider, Mohammad Humayun, Abidullah Khan
Classic Raymond syndrome presents with abducens nerve palsy on the ipsilateral side with contralateral hemiparesis and facial nerve paralysis. A 60-year gentleman presented with deviation of left angle of mouth and right sided weakness. Examination showed that he had left sided abducens nerve palsy, with contralateral central facial paralysis and paresis. MRI of brain confirmed left pontine infarct. These findings were consistent with classic Raymond syndrome. Till now, only a few cases have been reported worldwide, this being the first case reported in South Asia...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Sriramya Lapa, Sebastian Luger, Waltraud Pfeilschifter, Christian Henke, Marlies Wagner, Christian Foerch
BACKGROUND AND PURPOSE: Little is known about the frequency and the clinical characteristics of neurogenic dysphagia in pontine strokes. In this study, we sought to identify predictors for dysphagia in a cohort of patients with isolated pontine infarctions. METHODS: We included all patients admitted to our department between 2008 and 2014 having an acute (<48 hours after symptom onset) ischemic stroke in the pons, as documented by means of diffusion-weighted magnetic resonance imaging...
May 2017: Stroke; a Journal of Cerebral Circulation
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