title: Etiological mechanisms of isolated pontine infarcts based on arterial territory involvement.
abstract: BACKGROUND
  Pontine infarcts can be classified into four regions based on the vascular anatomy: anteromedial, anterolateral, lateral and posterior. The purpose of this study was to determine if different etiological mechanisms are responsible for these four types of pontine infarcts.
  
  
  METHODS
  We studied consecutive patients within 7 days of symptom onset who had isolated pontine infarcts on diffusion-weighted imaging. The factors associated with infarct topography were determined by multivariate logistic regression analysis.
  
  
  RESULTS
  A total of 205 patients were enrolled (78 women; mean age, 72 ± 11 years). The distribution of the infarcts was anteromedial in 73%, anterolateral in 14%, lateral in 3% and posterior in 10%. In multivariate logistic regression analysis, major cardioembolic sources (odds ratio (OR), 4.17; 95% confidence interval (CI), 1.21-14.1) and previous ischemic stroke (OR, 2.92; 95% CI, 1.09-7.89) were positively associated with lateral or posterior infarcts compared with anteromedial infarcts. In contrast, advanced age (OR, 0.55; 95% Cl, 0.35-0.81 per 10-year increase), diabetes mellitus (OR, 0.31; 95% CI, 0.11-0.80) and basilar artery disease (OR, 0.27; 95% CI, 0.08-0.75) were negatively associated with lateral or posterior pontine infarcts.
  
  
  CONCLUSIONS
  Baseline characteristics were significantly different among patients with isolated pontine infarcts in different topographic locations. Our results suggest that cardioembolism is relatively common in lateral or posterior pontine infarcts, whereas basilar artery atherosclerosis is more common in anteromedial infarcts.
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Kobayashi
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan. Electronic address: ohatomo@ncvc.go.jp.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ohara
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
authors.affiliation: Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nagatsuka
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001488:Basilar Artery / Q000473:pathology*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011149:Pons / Q000098:blood supply / Q000473:pathology*; D012189:Retrospective Studies
keywords: Basilar artery; Brain stem; Cardioembolism; Diffusion-weighted imaging; Risk factors; Stroke