Abstract
Thirty patients with infarction of the basis pontis were clinically evaluated in order to determine the clinical characteristics of the infarction resulting from occlusion of the mouth of the paramedian basilar branches (branch occlusion). Based on the MRI findings, the patients were divided into a B-group (branch occlusion) and an L-group (lacunar infarction). The B-group was defined as having infarcts confined to the territory of a single basilar paramedian branch and extending to the pontine basal surface, while the L-group had small (less than 15 mm) lesions isolated within the parenchyma. In the B-group, initial confusion was noted in 47% of the patients. All patients had dysarthria and hemiparesis. Progressive deterioration was observed in 80% of the patients. One third of the patients had a relatively poor outcome (moderate hemiparesis, dependent activities of daily life). In the L-group, all patients had a clear consciousness and classic lacunar syndrome. Progressive deterioration was rare (27% of the patients). All patients achieved a good outcome (independent activities of daily life). Comparing the risk factors, diabetes mellitus and hyperlipidemia were more common in the B-group than in the L-group. The differences between the two groups may reflect the size of the lesions and the pace and tempo of ischemia. It appeared that most cases of the B-group have branch athermatous disease.
