Relationship between topographic location and neurological deterioration in acute isolated pontine infarction

Objective To discuss the relationship between topographic location and neurological deterioration(ND)in patients with acute isolated pontine infarction. Methods Two hundred and fifty-nine patients with acute isolated pontine infarction, collected in our hospital from January 2010 to August 2013 and identified by diffusion weighted imaging(DWI), were included for retrospective review. Patients were divided into two groups according to their clinical symptoms: patients with ND and patients without ND. According to neuroimaging of DWI, the topographic location of pontine infarction was divided into three types: the upper, middle and lower ones; and the correlations of ND with risk factors, laboratory examination results, clinical manifestations and different topographic locations were explored by statistical tests. Results Of 259 patients, 27.4%(71)were diagnosed with ND; 72.6%(188)were diagnosed without ND. Univariate analysis showed that there were no differences in laboratory test results, NIHSS scores and medications between the two groups(P> 0.05); there were differences in female ratio(41[57.7%]vs. 82[43.6%]), smoking ratio(10[14.2%]vs. 49[26.2%]), mean length of hospital stay([22.72 ± 7.01]d vs.[19.42 ± 7.76]d), ratio of worse short-term clinical outcomes(56[78.87%]vs. 64[34.04%])and ratio of lower pontine infarction(31[43.7%]vs. 57[30.3% ])between the two groups(P<0.05). Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND(odds ratio=1.952, 95% confidence interval=1.081-3.524, P=0.027). Conclusion Topographic location of lower pons lesions may be reliable predictor of ND in acute isolated pontine infarction. Key words: Cerebral infarction; Pons; Neurological deterioration; Acute stage; Diffusion weighted imaging