Correlation Between Isolated Pons Infarction And Basilar Artery Vascular Lesions

Background and Objective: Isolated pons infarction(IPI)is a common type of brain stem infarction,accounting for 7% of all first-onset cerebral infarction.The clinical symptoms of solitary pons infarction are generally mild,and the long-term prognosis is good,but due to the anatomy of the pons Structural features,pons infarction symptoms and signs are more complicated,in addition to the classic pons syndrome,such as Foville syndrome,Millard Gubler syndrome,atresia syndrome,one and a half syndrome,etc.,can also be expressed as contralateral convulsions,cerebellum Frequent symptoms such as tremor,unilateral dystonia,eight and a half syndromes,nine syndromes,fifteen and a half syndromes.The most common classification methods for the pathogenesis of vascular disease at home and abroad: large-arteryocclusive disease(LAOD),basilar artery branching disease(BABD),small arterial disease(SAD).At present,with the help of magnetic resonance imaging(MRI),magnetic resonance angiography(MRA)and high resolution magnetic resonance imaging(HR-MRI),the infarction site of the pons and its blood supply artery lesions are easy to be identified,but there are many types of blood supply artery lesions.In addition to stenosis or occlusion,there are also basilar artery dolichoectasia(BAD)and basilar artery hypoplasia(BAH),this study further explored the correlation between isolated pons infarction and basilar artery vascular disease,and improved the understanding of the etiology of isolated pons.Methods: 72 patients with acute isolated pons infarction admitted to the Department of Neurology,Weihai Municipal Hospital from 2014 to 2016 were collected.The patients were divided into A(parapontine median type),B(ventral lateral type),C(pontine tegmental type)and D(mixed type),Basilar artery stenosis < 50%,basilar artery stenosis?50%,basilar artery dolichoectasia,basilar artery hypoplasia and no obvious vascular stenosis were classified according to MRA findings.The relationship between isolated pontine infarction and basilar artery angiopathy was analyzed.Results: Among the 72 patients,A,B,C,and D groups accounted for 42(58.3%),6(8.3%),6(8.3%),and 18(25%);those with basilar artery stenosis <50% were 18(25%),13 cases(18.1%)with basilar artery stenosis ?50%,14 cases(19.4%)with basilar arterydolichoectasia,4cases(5.6%)with basilar artery dysplasia,and 23(31.9%)cases without obvious vascular stenosis;the median infarction was associated with no significant vascular stenosis(P<0.05),mixed type was associated with basilar artery stenosis ?50%(P<0.05);basilar artery dolichoectasia were 26.2% in group A,is significantly higher than group B(16.7%),C group(16.7%),and D group(5.6%),but the difference between the four groups was not statistically significant(P = 0.321).Conclusion: Isolated pons infarction is closely related to basilar artery disease.For the patients with multiple branches of pontine blood supply area infarction,we should pay high attention to the possibility of serious stenosis of basilar artery,and do MRA and other vascular evaluation as early as possible.In addition,the etiology of parapontine infarction can not be determined only according to whether the basilar artery has stenosis.If atherosclerosis does not reach the degree of causing vascular stenosis,MRA alone may omit vascular lesions.For this kind of situation,HR-MRI is recommended to determine the vascular etiology,improve the detection rate of basilar artery vascular lesions in patients with isolated pontine infarction,and treat the etiology It is of great significance to judge the prognosis and prevent recurrence.