Research article

Pontine infarction with pure motor hemiparesis or hemiplegia: A prospective study

Li Ling^{* 1,2} , Liangfu Zhu^{* 1,3} , Jinsheng Zeng¹ , Songjie Liao¹ , Suping Zhang² , Jian Yu¹ and Zhiyun Yang⁴

¹Department of Neurology and Stroke Center, the First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou, 510080, PR China

²Department of Neurology, Guangzhou Red Cross Hospital, the Fourth Affiliated Hospital, Jinan University, No.396 Tongfuzhong Road, Guangzhou, 510220, PR China

³Department of Neurology, the People's Hospital of Henan Province, No. 7 Wei Wu Road, Zhengzhou, 450003, PR China

⁴Department of Radiology, the First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou, 510080, PR China

author email corresponding author email* Contributed equally

BMC Neurology 2009, 9:25doi:10.1186/1471-2377-9-25

Published:	15 June 2009

Abstract

Background

The study aimed to prospectively observe the clinical and neuroimaging features of pontine infarction with pure motor hemiparesis (PMH) or hemiplegia at early stage.

Methods

In 118 consecutive selected patients with the first-ever ischemic stroke within 6 hours after onset, fifty of them presented with PMH or hemiplegia and had negative acute computed tomography (CT) scans, then magnetic resonance imaging (MRI) confirmed the corresponding infarcts in pons or cerebrum. The clinical and neuroimaging features of the pontine infarctions were compared with those of cerebral infarctions.

Results

The pontine infarction with PMH or hemiplegia accounted for 10.2% (12/118) of all first-ever ischemic stroke patients and 24% (12/50) of the patients with both PMH or hemiplegia and acute negative CT scans. Compared to the patients with cerebral infarction, the patients with pontine infarction had more frequency of diabetes mellitus (50.0% vs 5.3%, P = 0.001), nonvertiginous dizziness at onset (58.3% vs 21.1%, P = 0.036) and a progressive course (33.3% vs 2.6%, P = 0.011).

Conclusion

The pontine infarction may present as PMH or hemiplegia with more frequency of nonvertiginous dizziness, a progressive course and diabetes mellitus. MRI can confirm the infarct location in the basal pons at early stage after stroke onset.