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Open Access Highly Accessed Research article

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

Li Ling12, Liangfu Zhu13, Jinsheng Zeng1*, Songjie Liao1, Suping Zhang2, Jian Yu1 and Zhiyun Yang4

Author Affiliations

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

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

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

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

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BMC Neurology 2009, 9:25  doi: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.