Pontine Infarction: A Prospective Cohort Study on Its Clinical Features, Prognosis, and Association with Branch Atheromatous Disease

Abstract

AbstractIntroductionThis study aimed to analyse disease characteristics and prognostic factors among a cohort of 407 patients with pontine infarction, focusing on the effect of branch atheromatous disease (BAD).Patients and MethodsA retrospective analysis of patients diagnosed with brainstem stroke at Baba Memorial Hospital from 2012 to 2022 was conducted. The study included patients with pontine stroke, excluding those with missing data, chronic or multiple cerebral infarctions, non-brainstem stroke, or without timely MRI. Patient analysis involved age, sex, Japan Coma Scale (JCS) score, medical history, symptoms at admission, and MRI findings. Prognostic groups were classified based on the modified Rankin Scale (mRS) and Functional Independence Measure (FIM) scores at admission and discharge.ResultsOf the 407 patients, 66.1% belonged to the good prognosis group (mRS 0–2) and 33.9% to the poor prognosis group (mRS 35). Younger patients tended to have a better prognosis. JCS scores correlated with prognosis severity. Significant differences in dysarthria, paralysis, and admission FIM scores were observed between patients with and without BAD. Logistic regression analysis identified the FIM score at admission as an independent predictor of prognosis.DiscussionBAD was not directly related to prognosis. The absence of differences in discharge FIM scores and similar prognoses to other stroke types suggested effective rehabilitation. However, due to the lack of pre-stroke FIM measurements and specific treatment details, further research is needed.ConclusionAge and JCS scores were significant prognostic factors, with BAD not directly affecting prognosis. There is need for investigation into treatment methods and detailed prognostic factors.