Pontine versus capsular pure motor hemiparesis.
We prospectively studied 21 patients with pure motor hemiparesis (PMH). CT showed a capsular lesion consistent with the clinical syndrome in 15 patients (71%) and was repeatedly negative in the remaining six (29%). In all six patients with repeatedly negative CT, MRI showed a pontine paramedian infarct as the notable cause of PMH. Clinical findings could not definitely distinguish between capsular and pontine PMH, but the combination of dysarthria and a history of previous transient gait abnormality or vertigo favored a pontine location. Outcome at 3 months was characterized by persistent, moderate to severe disability in 86% of patients with pontine PMH versus 46% in capsular PMH. Based on MRI and magnetic resonance angiographic findings, the presumed mechanism of pontine ischemic lesions was a lacunar process in most instances (86%).
Nighoghossian
N
N
Department of Neurology and Cerebrovascular Disease, Neurological Hospital, Lyon, France.
Ryvlin
P
P
Trouillas
P
P
Laharotte
J C
JC
Froment
J C
JC
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002544:Cerebral Infarction / Q000150:complications*; D005260:Female; D006429:Hemiplegia / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011149:Pons / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies