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Cerebral Infarction, Basilar Perforating Artery
Edward P. Quigley, III, MD, PhD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Pontine perforator stroke (PPS)
          • Definitions

            • Focal infarct in pons or pontomedullary junction secondary to pontine perforator or basilar branch artery ischemia

          IMAGING

          • General Features

            • Imaging Anatomy

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      CLINICAL ISSUES

                      • Presentation

                        DIAGNOSTIC CHECKLIST

                        • Consider

                          • Image Interpretation Pearls

                            Selected References

                            1. Kwon HM et al: Basilar artery dolichoectasia is associated with paramedian pontine infarction. Cerebrovasc Dis. 27(2):114-8, 2009
                            2. Puetz V et al: CT angiography source images predict final infarct extent in patients with basilar artery occlusion. AJNR Am J Neuroradiol. Epub ahead of print, 2009
                            3. Samaniego EA et al: Favorable outcome from a locked-in state despite extensive pontine infarction by MRI. Neurocrit Care. Epub ahead of print, 2009
                            4. Claassen DO et al: Locked-in or comatose? Clinical dilemma in acute pontine infarct. Mayo Clin Proc. 83(11):1197, 2008
                            5. Saposnik G et al: Pontine warning syndrome. Arch Neurol. 65(10):1375-7, 2008
                            6. Han Z et al: Spontaneous basilar artery dissection. Hong Kong Med J. 13(2):144-6, 2007
                            7. Buckle C et al: Bilateral pontine infarction secondary to basilar trunk saccular aneurysm. Arch Neurol. 63(10):1498-9, 2006
                            8. Lui YW et al: Perfusion and diffusion tensor imaging in a patient with locked-in syndrome after neurosurgical vascular bypass and endovascular embolization of a basilar artery aneurysm: case report. Neurosurgery. 58(4):E794; discussion E794, 2006
                            9. Erro ME et al: Isolated pontine infarcts: etiopathogenic mechanisms. Eur J Neurol. 12(12):984-8, 2005
                            10. Koch S et al: Diffusion-weighted magnetic resonance imaging in symptomatic vertebrobasilar atherosclerosis and dissection. Arch Neurol. 62(8):1228-31, 2005
                            11. Woolfenden AR et al: Basilar artery stenosis: clinical and neuroradiographic features. J Stroke Cerebrovasc Dis. 9(2):57-63, 2000
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Top Differential Diagnoses

                                  • Clinical Issues

                                    TERMINOLOGY

                                    • Synonyms

                                      • Pontine perforator stroke (PPS)
                                    • Definitions

                                      • Focal infarct in pons or pontomedullary junction secondary to pontine perforator or basilar branch artery ischemia

                                    IMAGING

                                    • General Features

                                      • Imaging Anatomy

                                        • CT Findings

                                          • MR Findings

                                            • Imaging Recommendations

                                              DIFFERENTIAL DIAGNOSIS

                                                CLINICAL ISSUES

                                                • Presentation

                                                  DIAGNOSTIC CHECKLIST

                                                  • Consider

                                                    • Image Interpretation Pearls

                                                      Selected References

                                                      1. Kwon HM et al: Basilar artery dolichoectasia is associated with paramedian pontine infarction. Cerebrovasc Dis. 27(2):114-8, 2009
                                                      2. Puetz V et al: CT angiography source images predict final infarct extent in patients with basilar artery occlusion. AJNR Am J Neuroradiol. Epub ahead of print, 2009
                                                      3. Samaniego EA et al: Favorable outcome from a locked-in state despite extensive pontine infarction by MRI. Neurocrit Care. Epub ahead of print, 2009
                                                      4. Claassen DO et al: Locked-in or comatose? Clinical dilemma in acute pontine infarct. Mayo Clin Proc. 83(11):1197, 2008
                                                      5. Saposnik G et al: Pontine warning syndrome. Arch Neurol. 65(10):1375-7, 2008
                                                      6. Han Z et al: Spontaneous basilar artery dissection. Hong Kong Med J. 13(2):144-6, 2007
                                                      7. Buckle C et al: Bilateral pontine infarction secondary to basilar trunk saccular aneurysm. Arch Neurol. 63(10):1498-9, 2006
                                                      8. Lui YW et al: Perfusion and diffusion tensor imaging in a patient with locked-in syndrome after neurosurgical vascular bypass and endovascular embolization of a basilar artery aneurysm: case report. Neurosurgery. 58(4):E794; discussion E794, 2006
                                                      9. Erro ME et al: Isolated pontine infarcts: etiopathogenic mechanisms. Eur J Neurol. 12(12):984-8, 2005
                                                      10. Koch S et al: Diffusion-weighted magnetic resonance imaging in symptomatic vertebrobasilar atherosclerosis and dissection. Arch Neurol. 62(8):1228-31, 2005
                                                      11. Woolfenden AR et al: Basilar artery stenosis: clinical and neuroradiographic features. J Stroke Cerebrovasc Dis. 9(2):57-63, 2000