The Predictive Factors For Progressive Motor Deficits After Isolated Pontine Infarction

Objective To identify the predictive factors for progressive motor deficits after isolated pontine infarction.Methods Consecutive patients of isolated pontine infarction admitted to hospital within 48 hours of the onset were collected. They were divided into either a PMD group(increase≥ 1 points within 7 d) or a non-PMD group according to the clinical course and the change of motor scores of the National Institutes of Health Stroke Scale(NIHSS). According to diffusion-weighted imaging, lesion pattern were classified as pontine infarction involving the basal surface and internal pontine infarction, left and right side, upper, middle and lower level. The demographics, baseline clinical data and imaging features were compared between the two groups. The logistic regression analysis were used to analyze the predictive factors for progressive motor deficits after isolated pontine infarction.Results A total of 101 patients with isolated pontine infarction were enrolled. 16 patients were diagnosed with PMD, and other 85 patients were among the non-PMD group. Compared with non-PMD group, the proportions of pontine infarction involving the basal surface(87.5% vs. 47.1%, χ2 = 8.851, P = 0.003), lesion located in the middle level(56.2% vs. 24.7%, χ2 = 4.851, P = 0.028) and basilar artery stenosis or occlusion(62.5% vs. 27.1%, χ2 = 7.689, P = 0.006) in PMD patients were significantly higher, while the proportion of infarct on the left side(18.8% vs. 56.5%, χ2 = 7.664, P = 0.006), and lesion located in the upper level(37.5% vs. 72.9%, χ2 = 7.689, P = 0.006) in PMDpatients was significantly lower than that of non-PMD group. Multivariate logistic regression analysis identified that pontine infarction involving the basal surface [odds ratio(OR) 5.650, 95% confidence interval(CI) 1.011 ~ 31.580, P = 0.049] and basilar artery stenosis or occlusion(OR 4.075, 95%CI 1.127~14.741, P = 0.032) were both independent risk factors for PMD after isolated pontine infarction.Conclusion Pontine infarction involving the basal surface and basilar artery stenosis or occlusion significantly are both associated with PMD after isolated pontine infarction. They could be important predictors for PMD.