Clinical Study Of Patients With Bilateral Cerebral Peduncle Infarction

Background: Bilateral cerebral peduncle infarction(BCPI) is an extremely rare neurological disorder; there is a little literature about it. This study investigated the clinical manifestations, magnetic resonance imaging(MRI) features and prognosis of BCPI.Method: Retrospectively reviewed the clinical manifestations, MRI and magnetic resonance angiography(MRA) features, and prognosis in 14 patients with BCPI confirmed by MRI diffusion-weighted imagine(DWI) from 5050 cerebral infarction patients at our medical center from January 2007 to June 2013. ASCO was used to classify the etiology of infarction,NHISS was used to assess the neurologic function deficit, the 90d’s MRS was used to assess prognosis, defined MRS≥grade 3 as poor prognosis.Result: Quadriplegia was observed in 11/14(78.6%) patients, decreased consciousness in 9/14(64.3%). At server stage peak, the National Institutes of Health Stroke Scale scores ranged from 4 to 26(mean score was 18.9). As for etiology, large artery atherosclerosis was amount for 11/14(78.6%) cases. Besides the bilateral cerebral peduncle, the other infarct locations were pons(12 patients, 85.7%; 9 bilateral), cerebellum(6 patients, 42.9%; 3 massive infarction, 4 bilateral), occipital lobe(5 patients, 35.7%; 4 bilateral), callosum(4 patients, 28.6%), thalamus(3 patients, 21.4%), temporal lobe(2 patients, 14.3%), and medulla(1 patient, 7.14%). Vertebra-basilar artery occlusion or severe stenosis was observed in 12/14(85.7%) patients, no collateral from posterior communicating artery was observed in 12/14(85.7%) patients, poor prognosis was in 13/14(92.9%) patients, among who 9 died.Occlusion: BCPI was very rare, it was associated with severe vertebrobasilar artery stenosis or occlusion and without collateral from posterior communicating artery, and its prognosis was very poor.