Paramedian Pontine Infarction

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Abstract
Background and Purpose There have been few reports of pontine syndromes secondary to paramedian pontine infarctions. To clarify the clinicotopographical correlation and prognosis of paramedian pontine infarct syndromes, we analyzed the clinical signs and their association with MRI findings. Methods We studied 49 patients with acute paramedian pontine infarcts and classified them into three subtypes on the basis of lesion location on MRI. Patient clinical status was assessed by Rankin Disability Scale (RDS) scores on admission and at 60 days after onset of stroke. Results Twenty-seven patients had basal infarcts. Clinical findings included dysarthria (n=27), hemiparesis with upper extremity predominance (n=15), brachial monoparesis (n=4), and pathological laughing (n=3). Fifteen patients had basal-tegmental infarcts. Clinical findings presented with hemiparesis and horizontal gaze abnormalities, including abducens nerve palsy (n=1), internuclear ophthalmoplegia (INO) (n=5), horizontal gaze palsy (n=1), one...