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what drives progressive motor deficits in patients with acute pontine infarction?

Neural Regeneration Research 2015年第3期10卷 501-504页

作者： Jue-bao Li Rui-dong Cheng Liang Zhou Wan-shun Wen Gen-ying Zhu Liang Tian Xiang-ming Ye Department of Rehabilitation Medicine Zhejiang Provincial People’s Hospital

Progressive motor deficits are relatively common in acute pontine infarction and frequently associated with increased functional disability. However, the factors that affect the progression of clinical motor weakness are largely unknown. Previous studies have suggested that pontine infarctions are caused mainly by basilar artery stenosis and penetrating artery disease. Recently, lower pons lesions in patients with acute pontine infarctions have been reported to be related to progressive motor deficits, and ensuing that damage to the corticospinal tracts may be respon- sible for the worsening of neurological symptoms. Here, we review studies on motor weakness progression in pontine infarction and discuss the mechanisms that may underlie the neurologic worsening.

关键词： nerve regeneration pontine infarction progressive motor deficits basilar artery pene-trating artery corticospinal tract Wallerian degeneration review neural regeneration

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Clinical and Radiological Features of Wallerian Degeneration of the Middle Cerebellar Peduncles Secondary to pontine infarction

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Chinese Medical Journal 2018年第6期131卷 665-671页

作者： Zhi-Yong Zhang Zhi-Qin Liu Wei Qin Ya-Wen Chen Zun-Jing Liu Department of Neurology China-Japan Friendship Hospital Beijing 100029 China Department of Neurology Xi'an Central Hospital Xi'an Jiaotong University School of Medicine Xi'an Shaanxi 710003 China Department of Neurology Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China

Background： Wallerian degeneration （WD） of bilateral middle cerebellar its characteristics have not yet been clarified because of the low incidence peduncles （MCPs） can occur following pontine infarction, but Thus, the present study discussed the clinical and radiological features to improve the awareness of this disease. Methods： Clinical and radiological information from consecutive individuals diagnosed with WD of bilateral MCPs following pontine infarction in three hospitals over the past 4 years between October 2012 and October 2016 were retrospectively investigated and compared with a control group （patients with pontine infarction had no secondary WD）. Results： This study involved 30 patients with WD of MCPs, with a detection rate of only 4.9%. The primary infarctions （χ2 -24.791, P = 0.001, vs. control group） were located in the paramedian pons in 21 cases （70.0%）, and ventrolateral pons in nine cases （30.0%）. WD of the MCPs was detected 8-24 weeks after pons infarction using conventional magnetic resonance imaging （M RI）; all secondary WDs were asymptomatic and detected incidentally. All WD lesions exhibited bilateral, symmetrical, and boundary blurring on MRI. The signal features were hypointense on Tl-weighted imaging, hyperintense on T2-weighted imaging and fluid-attenuated inversion recovery, and slightly hyperintense or isointense on diffusion-weighted imaging and apparent diffusion coefficient maps. Secondary brainstem atrophy was found in six （20.0%） cases. A Modified Rankin Scale score 0-2 was found in 10 （33.3%） cases and score 〉2 in 20 （66.7%） cases at 90 days after discharge, and the short-term prognosis was worse than that in control group （χ2 =12.814, P - 0.001 ）. Conclusions： Despite the rarity of bilateral and symmetrical lesions of MCPs, secondary WD should be highly suspected if these lesions occur within 6 months after pontine infarction, particularly parainedian ports. Conventional MRI appears to be a relatively sensitive method for detec

关键词： Magnetic Resonance Imaging Middle Cerebellar Peduncles Neurological Prognosis pontine infarction WallerianDegeneration

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Restless legs syndrome secondary to pontine infarction:Clinical analysis of five cases

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Chronic Diseases and Translational Medicine 2017年第3期3卷 186-190页

作者： Hou-Zhen Tuo Ze-Long Tian Yi-Nong Cui Xiao-Yang Ma Chun-Ling Xu Hong-Yan Bi Li-Yan Zhang Yong-Bo Zhang Wei-Dong Le William Ondo Department of Neurology Capital Medical University Affiliated Beijing Friendship Hospital Beijing 100050 China Department of Neurology The Fourth Central Hospital of Tianjin Tianjin 300140 China Department of Neurology Beijing Ditan Hospital Capital Medical University Beijing 100015 China The Center for Translational Research on Neurological Diseases The First Affiliated Hospital of Dalian Medical University Dalian Liaoning 116011 China Department of Neurology Methodist Neurological Institute Houston TX 77030 USA

Objective: pontine infarction is a common type of stroke in the cerebral deep structures, resulting from occlusion of small penetrating arteries, may manifest as hemi-paralysis, hemi-sensory deficit, ataxia, vertigo, and bulbar dysfunction, but patients presenting with restless legs syndrome (RLS) are extremely rare. Herein, we reported five cases with RLS as a major manifestation of pontine ***: Five cases of pontine infarction related RLS were collected from July 2013 to February 2016. The diagnosis of RLS was made according to criteria established by the International RLS Study Group (IRLSSG) in 2003. Neurological functions were assessed according to the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Severity of RLS was based on the International RLS Rating Scale (IRLS-RS). Sleep quality was assessed by Epworth Rating Scale (ERS), and individual emotional and psychological states were assessed by Hamilton Depression Scale (HDS) and Hamilton Anxiety Scale (HAS).Results: The laboratory data at the onset including hemoglobin, serum concentration of homocysteine, blood urea nitrogen (BUN), creatinine, electrolytes, and thyroid hormones were normal. The electroencephalogram (EEG), lower-extremity somatosensory evoked potential (SEP), and nerve conduction velocity (NCV) in four limbs were normal. The average period of follow-up was 34.60 ± 12.76 months. The MRI examination showed acute or subacute pontine infarction lesions, 3 cases in the rostral inner side, 1 case in the rostral lateral and inner side, and 1 case in rostral lateral side. The neurological deficits included weakness in 4 cases, contralateral sensory deficit in 1 case, and ataxia in 2 cases. All 5 patients presented with symptom of RLS at or soon after the onset of infarction and 4 patients experienced uncomfortable sensations in the paralyzed limbs contralateral to the ischemic lesion. Their neurological deficits improved significantly 2 weeks later,

关键词： Restless legs syndrome pontine infarction Clinical features

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Millard-Gubler Syndrome in a Patient with pontine infarction: A Case Report

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Open Journal of Clinical Diagnostics 2023年第2期13卷 23-28页

作者： Hamdan Iftikhar Siddiqui Rangraze Imran Rashid Aseilah Qaidy Department of Internal Medicine RAK Medical & Health Sciences University (RAKMHSU) Ras Al Khaimah (RAK) UAE Department of Medicine Fujairah Hospital Fujairah UAE

Millard-Gubler Syndrome is a rare neurological condition caused by damage to the sixth and seventh cranial nerves, as well as the corticospinal tract in the brainstem. It is characterized by the presence of ipsilateral facial paralysis and contralateral hemiplegia. We report a 55-year-old male patient who presented with sudden onset of left-sided weakness. Imaging revealed a pontine infarct. The patient therefore, was diagnosed with Millard-Gubler Syndrome also known as Ventral pontine Syndrome based on his symptoms and imaging findings. He was treated with Aspirin and Atorvastatin and was referred to neurology for further consultation and to physiotherapy for his weakness. This case report highlights the importance of prompt recognition and diagnosis of Millard-Gubler Syndrome in patients with pontine infarction. Early identification especially with the use of high-resolution MRI can facilitate appropriate management and treatment, ultimately improving patient outcomes.

关键词： Millard Gubler Syndrome Case Report Ischemic Stroke pontine infarction

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