Brainstem Infarction: A Patient Of Pontine Infarction With The Clinical Manifestation Of Encephalitis

Objective:Brainstem infarctions may develop a rapid deterioration in neurological status leading to death. However, much more cases of atypical brainstem infarction are reported nowadays since the development of radiology. In this study, a rare case of pontine infarction with the clinical manifestation of encephalitis was reported, and the clinical features of brainstem infarction would be discussed.Methods:A rare case of pontine infarction with the clinical manifestation of encephalitis was reported. The related literatures in recent years are reviewed and the clinical features of brainstem infarction were discussed.Results:Pons is the most common location of brainstem infarction. Atherosclerosis and thrombosis of basal artery and its branches are the main causes of brainstem infarction. 1. The clinical manifestations of brainstem infarction are complex and diverse. Atypical brainstem infarction are often be reported as three types basically:the seemingly hemisphere lesion, the seemingly vertebrobasilar artery lesions and the asymptomatic brainstem infarction.3. MRI examination, especially the DWI imaging, is of great importance for the diagnosis of brain stem infarction. Early negative diffusion-weighted imaging can not rule out the diagnosis of brainstem infarction. Repeat DWI studies may be indicated when the clinical presentation suggests an infarction.4. The time-frame of thrombolytic therapy for brainstem infarction has not defined yet. However, thrombolytic therapy has been confirmed to be safe, and can effectively reduce the morbidity.Conclusions:The clinical manifestation of brainstem infarction clinical is diverse. Atypical brainstem infarctions may be misdiagnosed. MRI would be the first choice of diagnosis of brainstem infarction. Initially negative DW MRI studies do not exclude a brainstem infarction. Repeat DW MRI studies may be indicated when the clinical presentation suggests an infarction despite an initial negative study. Thrombolytic therapy may improve the clinical outcome and reduce mortality in the treatment of acute brainstem infarction.