급성 뇌교 경색의 임상연구

Abstract

Background : In a pontine infarction, variable neurologic deficits present because the pons is very complicated organ including cranial nerve nuclei and several fiber tracts. It's the aim of this study to clarify the clinicotopographical correlation of isolated acute pontine infarcts. Methods : We studied 33 patients with acute pontine infarct and classified them into three subtypes on the basis of lesion location on MRI. Clinical features, angiographic findings and risk factors were compared. Results : Twelve patients had a ventromedial pontine infarcts, in which clinical findings included dysarthria (N=12), hemiparesis (N=12) and tegmental signs (N=6). Five patients had a ventrolateral pontine infarcts, in which clinical findings included vertigo (N=3), hemiparesis (N=3) and sensory disturbances (N=2). Fifteen patients had a tegmental infarcts, in which clinical findings were vertigo (N=13), eye movement disorders (N=10) such as abducence palsy; inter-nuclear opthalmoplegia, ocular bobbing, and sensory disturbance (N=4). Emboligenic heart disease (N=3/33 9.1%) and sign-ificant stenosis of vertebro-basilar artery (3/16 18.7%) were observed. Summary: Corresponding to territories of intrinsic pontine vessels, isolated pontine infarcts could be classified into three main syndromes. Isolated pontine infarcts were usually due to thrombosis of per-forating arteries, but large artery stenosis and cardioembolism also could be causes of isolated pontirie infarcts.