Severe White Matter Hyperintensity Is Associated with Early Neurological Deterioration in Patients with Isolated Pontine Infarction

被引:16
|
作者
Nam, Ki-Woong [1 ]
Lim, Jae-Sung [2 ]
Kang, Dong-Wan [1 ]
Lee, Yong-Seok [1 ]
Han, Moon-Ku [3 ]
Kwon, Hyung-Min [1 ]
机构
[1] Seoul Natl Univ, Boramae Med Ctr, Seoul Metropolitan Govt, Dept Neurol, 20 Boramae Ro 5 Gil, Seoul 156707, South Korea
[2] Hallym Univ, Sacred Heart Hosp, Dept Neurol, Anyang, South Korea
[3] Seoul Natl Univ, Bundang Hosp, Dept Neurol, Songnam, South Korea
关键词
Leukoaraiosis; Prognosis; Ischennic stroke; PROGRESSIVE MOTOR DEFICITS; SMALL SUBCORTICAL INFARCTION; SMALL VESSEL DISEASE; LACUNAR INFARCTION; BASILAR ARTERY; ISCHEMIC LEUKOARAIOSIS; STROKE; MARKERS; LESIONS; MRI;
D O I
10.1159/000448888
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: Pontine infarction is a common type of brain stem infarction and early neurological deterioration (END). We evaluated the possibility of severe white matter hyperintensity (WMH) as a predictor of END in isolated pontine infarction. Methods: We recruited 2 types of patients with isolated pontine infarction within 24 h from symptom onset. END was defined as an increase of >= 1 point on the motor National Institutes of Health Stroke Scale (NIHSS) or >= 2 points on the total NIHSS score within 72 h from admission. We graded WMH using Fazekas scale, which is dichotomized into mild (grades 0-1) and moderate to severe (grades 2-3) on fluid attenuated inversion recovery images. Results: A total of 82 patients with an isolated pontine infarction were selected. END was detected in 23 patients (28%). Severe periventricular and subcortical WMH (PVWMH and SCWMH, respectively) were more frequent in deteriorating patients (p = 0.001 and p = 0.019, respectively). A logistic regression analysis revealed that both severe PVWMH (OR 6.17; 95% CI 1.93-19.75, p = 0.002) and SCWMH (OR 3.19; 95% C11.10-9.23, p = 0.032) remained independent predictors of END. Conclusions: Both severe PVWMH and SCWMH were useful to predict END in patients with isolated pontine infarction. (C) 2016 S. Karger AG, Basel
引用
收藏
页码:117 / 122
页数:6
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