J Stroke.
2018 Jan;20(1):92-98. 10.5853/jos.2017.00829.
Basilar Artery Plaque and Pontine Infarction Location and Vascular Geometry
- Affiliations
-
- 1Department of Neurology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea. dichang@khmc.or.kr
- 2Department of Radiology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.
- 3Department of Neurology, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea.
- 4Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea.
- KMID: 2424440
- DOI: http://doi.org/10.5853/jos.2017.00829
Abstract
- BACKGROUND AND PURPOSE
Subclinical atherosclerotic plaques are common in patients with pontine infarctions (PIs) but without basilar artery (BA) stenosis. We hypothesized that BA plaque locations may differ by PI type and vertical location as well as vertebrobasilar artery geometry.
METHODS
Ninety-six patients with PI but without BA stenosis on magnetic resonance imaging (MRI) and magnetic resonance angiography were enrolled. PIs were classified by type (paramedian, deep, or lateral) and vertical location (rostral, middle, or caudal). Patients underwent high-resolution MRI to evaluate BA plaque location (anterior, posterior, or lateral). The mid-BA angle on anteroposterior view and angle between the BA and dominant vertebral artery (BA-VA angle) on lateral view were measured.
RESULTS
The PIs were paramedian (72.9%), deep (17.7%), and lateral (9.4%) type with a rostral (32.3%), middle (42.7%), and caudal (25.0%) vertical location. The BA plaque locations differed by PI type (P=0.03) and vertical location (P < 0.001); BA plaques were most frequent at the posterior wall in paramedian (37.1%) and caudal (58.3%) PIs and at the lateral wall in lateral (55.5%) and middle (34.1%) PIs. The BA-VA and mid-BA angles differed by BA plaque and PI vertical location; the greatest BA-VA angle was observed in patients with posterior plaques (P < 0.001) and caudal PIs (P<0.001). Greatest mid-BA angles were observed with lateral BA plaques (P=0.03) and middlelocated PIs (P=0.03).
CONCLUSIONS
Greater mid-BA angulation may enhance lateral plaque formation, causing lateral and middle PIs, whereas greater BA-VA angulation may enhance posterior plaque formation, causing paramedian or caudal PIs.
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