title: Rostrocaudal thickness on sagittal diffusion-weighted imaging as a predictor of motor deficits in an acute isolated pontine infarction.
abstract: BACKGROUND
  The relationship between infarct dimensions and neurologic severity in patients with acute pontine infarctions remains unclear. This study aimed to clarify the morphometric predictive value of magnetic resonance imaging for motor deficits in pontine infarction.
  
  
  METHODS
  Nineteen patients with an acute pontine infarction (12 males and 7 females, 70.6 ± 13.5 years [mean age ± SD]) had ventrodorsal length and rostrocaudal thickness and width retrospectively measured as parameters of infarct size on axial and sagittal diffusion-weighted imaging (DWI). Each patient's functional score (FS) based on Brunnstrom scale (upper limb, hand, and lower limb) was assessed. The functional score of bulbar symptoms was coded as follows: 2, none; 1, dysarthria or dysphasia; and 0, both. The mean FS was compared with each infarct size parameter and the patients' clinical features.
  
  
  RESULTS
  Rostrocaudal thickness on sagittal DWI was the parameter most closely correlated with FS (Spearman rank correlation coefficient (rs) = -.474, P = .040). However, there is apparently no association between FS and infarct size with correction for age. FS was most severe in patients with an atherothrombotic infarction; it was mildest in patients with a lacunar infarction (value of K [Kruskal-Wallis] = 9.0, P = .015).
  
  
  CONCLUSIONS
  The branch orifices of the pontine paramedian arteries could be narrowed by atheromatous plaques within the basilar artery. These atheromatous lesions involving multiple branching paramedian arteries probably cause rostrocaudally thick infarctions. A pontine infarction extending rostrocaudally along the corticospinal tract may cause severe motor impairments.
authors.affiliation: Department of Neurology, Todachuo General Hospital, Toda-shi, Japan; Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Neurology, Todachuo General Hospital, Toda-shi, Japan; Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: ttakeda@nij.twmu.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Takeda
authors.affiliation: Department of Neurology, Todachuo General Hospital, Toda-shi, Japan.
authors.forename: Kuniko
authors.initials: K
authors.lastname: Ohara
authors.affiliation: Department of Neurology, Todachuo General Hospital, Toda-shi, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tei
authors.affiliation: Department of Neurology, Todachuo General Hospital, Toda-shi, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Nishizawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D004185:Disability Evaluation; D004401:Dysarthria / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011149:Pons / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Branch atheromatous disease; diffusion-weighted image; pontine infarction; predictive value