Basilar Artery Plaque and Pontine Infarction Location and Vascular Geometry
- Author:
Bum Joon KIM
1
;
Kyung Mi LEE
;
Hyun Young KIM
;
Young Seo KIM
;
Seong Ho KOH
;
Sung Hyuk HEO
;
Dae Il CHANG
Author Information
- Publication Type:Original Article
- Keywords: Brain stem infarctions; Basilar artery; Plaque, atherosclerotic; Hemodynamics; Magnetic resonance angiography
- MeSH: Arteries; Basilar Artery; Brain Stem Infarctions; Constriction, Pathologic; Hemodynamics; Humans; Infarction; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Plaque, Atherosclerotic; Vertebral Artery
- From:Journal of Stroke 2018;20(1):92-98
- CountryRepublic of Korea
- Language:English
- 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.
