Basilar artery atherosclerotic disease is related to subacute lesion volume increase in pontine base infarction

• Published in: Acta neurologica Scandinavica Vol. 120; no. 2; pp. 88 - 93
• Main Authors: Kim, J. S., Cho, K.-H., Kang, D.-W., Kwon, S. U., Suh, D. C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-08-2009; Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; Atherosclerosis - complications; Atherosclerosis - pathology; basilar artery; Basilar Artery - pathology; Biological and medical sciences; Brain Stem Infarctions - etiology; Brain Stem Infarctions - pathology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Diffusion Magnetic Resonance Imaging; Female; Humans; infarction; Male; Medical sciences; Middle Aged; Neurology; pons; Pons - blood supply; Pons - pathology; Prognosis; Retrospective Studies; Vascular disease; pons; Nervous system diseases; Infarct; Atherosclerosis; infarction; Cardiovascular disease; Basilar artery; Circulatory system; Lesion; Subacute
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/j.1600-0404.2008.01124.x

Background –  Although basilar artery atherosclerotic disease (BAD) is frequent in patients with pontine base infarction, it remains unknown whether BAD is related to the lesion size or clinical outcome.
Methods –  We studied 56 patients with unilateral pontine base infarction who underwent (i) diffusion‐weighted MRI within 48 h after stroke onset and (ii) follow‐up MRI and MR angiography in the subacute stage. Neurologic progression was defined as increased National Institutes of Health Stroke Scale score by ≥ 2 during admission. Clinical outcome was dichotomized as good and poor (≥ 3) according to the modified Rankin Scale at 1 month after stroke onset.
Results –  Twenty‐two patients (39%) had BAD and 15 patients (27%) had neurologic progression. Follow‐up MRI performed at median 3.5 ± 1.1 days after the initial MRI showed the lesion volume significantly increased (P < 0.001). The BAD was not significantly related to demographic characteristics, risk factors, initial and follow‐up lesion volume, neurologic progression and clinical outcome, but was closely related to the subacute increase in lesion volume (P = 0.004 for 20% increase, P = 0.029 for 50% increase).
Conclusions –  BAD is related to subacute increase in lesion volume, but not to ultimate poor clinical outcome in patients with pontine base infarction.