title: Severe White Matter Hyperintensity Is Associated with Early Neurological Deterioration in Patients with Isolated Pontine Infarction.
abstract: Pontine infarction is a common type of brain stem infarction and early neurological deterioration (END). We evaluated the possibility of severe white matter hyperintensity (WMH) as a predictor of END in isolated pontine infarction.
  
  
  
  We recruited 2 types of patients with isolated pontine infarction within 24 h from symptom onset. END was defined as an increase of ≥1 point on the motor National Institutes of Health Stroke Scale (NIHSS) or ≥2 points on the total NIHSS score within 72 h from admission. We graded WMH using Fazekas scale, which is dichotomized into mild (grades 0-1) and moderate to severe (grades 2-3) on fluid-attenuated inversion recovery images.
  
  
  
  A total of 82 patients with an isolated pontine infarction were selected. END was detected in 23 patients (28%). Severe periventricular and subcortical WMH (PVWMH and SCWMH, respectively) were more frequent in deteriorating patients (p = 0.001 and p = 0.019, respectively). A logistic regression analysis revealed that both severe PVWMH (OR 6.17; 95% CI 1.93-19.75, p = 0.002) and SCWMH (OR 3.19; 95% CI 1.10-9.23, p = 0.032) remained independent predictors of END.
  
  
  
  Both severe PVWMH and SCWMH were useful to predict END in patients with isolated pontine infarction.
authors.affiliation: Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Ki-Woong
authors.initials: KW
authors.lastname: Nam
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Lim
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Kang
authors.forename: Yong-Seok
authors.initials: YS
authors.lastname: Lee
authors.forename: Moon-Ku
authors.initials: MK
authors.lastname: Han
authors.forename: Hyung-Min
authors.initials: HM
authors.lastname: Kwon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020526:Brain Stem Infarctions / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D049292:Leukoaraiosis / Q000175:diagnosis*; D056784:Leukoencephalopathies / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011149:Pons / Q000098:blood supply* / Q000473:pathology; D056910:Republic of Korea