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The clinical presentations included pure motor hemiparesis(PMH)in 17, sensorimotor stroke in 3,ataxic hemiparesis(AH)in 5,and dysarthria-clumsy hand(DA-CH)syndrome in 6 patients.Variants of AH included 1 patient with dysarthria-hemiataxia and 2 with quadrataxic hemiparesis,and in 4 patients dysarthria-facial syndrome was considered a variant of DA-CH syndrome. Hypertension was the single most common and important risk factor and the pathogenetic mechanisms of ischemia were likely to be small arterial (lacunar)occlusion or basilar atheromatous branch occlusion in most of the patients.Our clinical-radiological correlation study suggested that large lesions involving the paramedian caudal or middle pons correlate with severe hemiparesis(PMH)whereas lesions of similar size located in the paramedian rostral pons tended to produce DA-CH syndrome.Lesions producing AH were located variously but tended to spare the pyramidal tracts.The prognosis of these patients is fair or good,although residual hemiparesis remained in patients with initially severe hemiparesis.Our data suggests that the various lacunar syndromes that follow pontine base infarcts reflect the balance of the involvement of the corticospinal, corticopontocerebellar,and corticobulbar tract.Analysis of radiologic findings aids in determining the clinical anatomic correlation in patients with pontine based infarction. |
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ataxic hemiparesis
brainstem,infarction of
brainstem,syndrome
cerebrovascular accident
dysarthria-clumsy hand syndrome
hypertension
lacunar infarction
pons,infarction of
pure motor hemiplegia
review article
risk factors
sensorimotor stroke
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