title: Basilar plaque on high-resolution MRI predicts progressive motor deficits after pontine infarction.
abstract: BACKGROUND
  The association between progressive motor deficits (PMD) in acute pontine infarction and basilar stenosis is unclear. High resolution MRI (HRMRI) is an emerging tool for basilar artery evaluation and might provide more accurate information. We aimed to analyze the association between basilar plaque assessed by HRMRI and PMD after acute pontine infarction.
  
  
  METHODS
  We identified consecutive patients with unilateral pontine infarction within 24 h of stroke onset. All the patients underwent diffusion weighted MRI, MR angiography and HRMRI within 24 h of admission. PMD was defined as an increase in National Institutes of Health Stroke Scale score by ≥1 during hospitalization. Factors potentially associated with PMD were validated by multivariate analyses.
  
  
  RESULTS
  Of a total of 87 patients, 63 (72%) had paramedian pontine infarction (PPI) and PMD was observed in 28 (32%) patients. Apparent basilar plaque assessed by HRMRI was more frequent in those with PMD than in those without PMD (52% versus 33%, p<0.001). In contrast, the frequency of basilar stenosis (>30%) assessed by MR angiography was similar regardless of PMD. In the patients with PPI, PMD was associated with hypertension and apparent plaque on HRMRI. After adjusting covariates, PMD was independently associated with apparent plaque on HRMRI (OR, 9.1; 95% CI 1.4-58.9).
  
  
  CONCLUSIONS
  Our results suggest that basilar plaque assessed by HRMRI is associated with PMD in patients with acute unilateral pontine infarction. Since basilar stenosis may be underestimated by MR angiography, HRMRI may provide additional information for predicting PMD and evaluating basilar artery stenosis.
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Sung-Hwan
authors.initials: SH
authors.lastname: Lim
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Hojin
authors.initials: H
authors.lastname: Choi
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Hee-Tae
authors.initials: HT
authors.lastname: Kim
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Juhan
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Sung Hyuk
authors.initials: SH
authors.lastname: Heo
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Dae-il
authors.initials: DI
authors.lastname: Chang
authors.affiliation: Department of Radiology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Radiology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Young-Jun
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Hyun Young
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea. Electronic address: aescula@hanmail.net.
authors.forename: Young Seo
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000368:Aged; D001488:Basilar Artery / Q000473:pathology*; D020526:Brain Stem Infarctions / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D002533:Cerebral Angiography / Q000379:methods*; D016009:Chi-Square Distribution; D038524:Diffusion Magnetic Resonance Imaging; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D000068079:Motor Disorders / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D015999:Multivariate Analysis; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D011149:Pons / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000473:pathology / Q000503:physiopathology
keywords: Basilar plaque; High-resolution MRI; Pontine infarction; Progressive motor deficit