No abstract available.
Hemorrhage ; Hypotension, Orthostatic ; Pons

BACKGROUND AND OBJECTIVES: Body lateropulsion with falling to one side is a well-known clinical feature of stroke in the posterior circulation. Body lateropulsion as an isolated or predominant manifestation of a pontine stroke has not previously been reported. To elucidate the possible mechanisms of patients presenting with body lateropulsion as an isolated or predominant symptom of isolated pontine infarction. MATERIALS AND METHOD: Between May 2004 and February 2006, out of 134 admitted patients with an isolated pontine stroke we identified 8 consecutive patients (6.0%) in the Keimyung University Stroke Registry who had body lateropulsion as the main presenting symptom. RESULTS: All lesions were localized to the paramedian tegmentum just ventral to the 4th ventricle. All except 1showed a uniform pattern of body lateropulsion, in which the direction of falling was away from the side of infarct. In 2 patients, body lateropulsion was the sole clinical manifestation, whereas the other patients had other neurological signs. All but 1 had contraversive tilting of the subjective visual vertical (SVV). In all cases, the direction of SVV tilt corresponded to the direction of body lateropulsion. The mean net tilt angle was 6.1 CONCLUSION: Based on the known anatomy of ascending vestibular pathways, the SVV tilting, and MRI findings, body lateropulsion probably results from damage to the graviceptive pathway ascending through paramedian pontine tegmentum.
Humans ; Infarction* ; Magnetic Resonance Imaging ; Pons ; Stroke

PURPOSE: To evaluate the size of normal pons and cerebellum in vivo and the change in size according to age, and to compare those with measurement of the diseased pons and cerebellum. MATERIALS AND METHODS: 121 normal adults(M:F=54:67), 5 patients with OPCD and 19 patients with WallerJan degeneration were studied. The normal group was divided into 5 subgroups according to the age (ranged from 20 to 72 years). 1.5T GE Signa MR unit was used. On axial plane, the AP(A) and transverse(B) diameters of the pons, the size of the middle cerebellar peduncle(C), and transverse diameter of the posterior fossa(D) and the cerebellum(E) were measured. On midsagittal plane, the longitudinal(F) and AP(G) diameters of the basis pontis were measured. The ratios of E/D and F/G were calculated. The student t test was used for statistical analysis. RESULTS: C, E and F/G were 15.5mm+/-1.3, 99.8mm+/-4.3 and 1.63+/-.10, respectively. F/G, H/I, and H/J were larger in male(p<.01). All data of the pons showed no statistically significant differences among age groups. E of the seventh decades was shorter than that of the third decades(p<.05). C(12.7 mm+/-1.4) in OPCD and F/G(1. 81+/-.10) in Wallerian degeneration(p<.01) showed the most significant differences when they were compared to the normal. CONCLUSION: Although the cerebellum decreased in size with age, the pons maintained its size up to eighth' decades. The measurement of middle cerebellar peduncle on axial plane (C) and the ratio of basis pontis on midsagittal plane (F/G) were important in the evaluation of OPCD and WallerJan degeneration, respectively.
Cerebellum* ; Humans ; Magnetic Resonance Imaging* ; Pons*

Presented here is an extremely rare case of intradural extraosseous chordoma with tenacious adhesion to the pons During the 5 years' follow-up period, the tumor has recurred locally twice in the prepontine region despite radical excisions and final irradiation with gamma knife. Magnetic resonance image obtained 1 year after radiosurgery demonstrated a new intradural mass growing above the tentorial hiatus, whereas the mass within the pons was markedly reduced. High resolution computed tomographic scan showed no evidence of bone involvement. Even though intradural location without bone involvement is a relatively benign occurrence, the recurrent pattern suggests an aggressiveness that correlates classic chordoma because of its invasion to the pons. Adjuvant radiotherapy will be required in this case for a long-term control.
Chordoma* ; Follow-Up Studies ; Pons ; Radiosurgery ; Radiotherapy, Adjuvant ; Recurrence

No abstract available.
Arteries* ; Hearing Loss, Sudden* ; Hearing Loss, Unilateral ; Infarction* ; Pons

The success of treating basilar aneurysms lies in the preservation of all perforating arteries and best selection of the surgical approaches. The purpose of this study was to define the microsurgical anatomy of the basilar artery and surgical approaches to the basilar artery. The microsurgical anatomy of the basilar artery and its branches were evaluated in adult cadaveric brains using 3x to 20x magnification. The branches of the basilar artery can be divided into three main groups: the cerebellar, lateral pontine, and perforating arteries. The lateral pontine arteries arise from the basilar trunk and course laterally to the brachium pontis. The perforating arteries originated from the basilar trunk and penetrating near the midline of the pons on its basal surface. The basilar trunk was approached via subtemporal-transtentorial, anterior transpetrosal, posterior transpetrosal and transchondylar routes. Selection of approach for basilar aneurysms was discussed.
Adult ; Aneurysm* ; Arteries ; Basilar Artery* ; Brain ; Cadaver ; Humans ; Pons

PURPOSE: The purposes of this study are to evaluate normal MR spectroscopy (MRS) data of the cerebellum and pons, and to evaluate intra-unit and inter-unit differences of the results. MATERIALS AND METHODS: Nine normal volunteers (mean age 23 years) were studied with two 1.5 Tesla MR units (A and B units). A total of four sessions of MRS study were performed with two sessions in each MR unit in each volunteer. In each session, MRS data were obtained from bilateral cerebellar hemisphere and pons. MRS was performed using spin-echo single voxel technique with repetition time of 2000 ms, echo time of 288ms and 128 averagings. Voxel size was 2x2x1.5 cm in the cerebellum and 1.5x1.5x1.5 cm in the pons. Metabolite ratios of NAA/Cho, NAA/Cr, NAA/(Cho+Cr) and Cr/Cho (both peak heights and the peak areas) were compared among the results of four sessions of MRS for evaluation of intra-unit and inter-unit differences. RESULTS: In the cerebellum, mean ISD values of peak height NAA/Cho, NAA/Cr, NAA/(Cho+Crl) and Cr/Cho ratios obtained in the first session of A unit were 1.08+/-0.16, 1.44+/-.286, 0.61+/-.09 and 0.76+/-,13, respectively. Comparing with the results of the second session, intra-unit differences were 3-7%. In B unit intra-unit differences were 1-9% , except for 22% of Cr/Cho ratio. Inter-unit differences between A and B units were 1-26%. In the pons, mean (SD values of peak height NAA/Cho, NAA/Cr, NAA/(Cho+Crl and Cr/Cho ratios obtained in the first session of A unit were 1.51+/-.35, 3.35+/-.78, 1.02+/-.16 and 0.47+/-,14, respectively. Mean NAA/Cho, NAA/Cr and NAA/(Cho+Cr) ratios of the pons were significantly higher than those of the cerebellum. Intra-unit differences were 2-21% in A unit and 4-l8% in B unit. Inter-unit differences between A and B units were 1-l8%. The mean values obtained by using peak area were generally higher and wider in range than those of peak height in both units. CONCLUSION: Mean NAA/Cho, NAA/Cr and NAA/(Cho+Cr) ratios of the cerebellum were significantly lower than those of the pons. Intra-unit differences of most metabolites ratios were generally not significant, whereas inter-unit differences were greater than intra-unit differences in more metabolite ratios. Therefore, normal MRS data of the cerebellum and the pons should be obtained in every MR unit, before MRS applications in the diseases of the cerebellum and the pons.
Cerebellum* ; Healthy Volunteers ; Magnetic Resonance Spectroscopy ; Pons* ; Spectrum Analysis ; Volunteers

We used cholera toxin B subunit (CTB) as a neural tracer to localize motor neuronal cell bodies innervating the digastric muscle. After CTB injection into the left anterior belly, CTB-labelled motor neuronal cell bodies were found in caudal half of the left and right trigeminal nucleus, the left and right facial nucleus, the accessory facial nucleus and the accessory trigeminal nucleus in pons. The total number of CTB-labelled motor neuronal cell bodies were 1,179+/-119.5 in the left pons and 246+/-61.8 in the right pons after CTB injections into the left anterior belly of digastric muscle. After CTB injection into left posterior belly, CTB-labelled motor neuronal cell bodies were found only in the left ventral part of accessory facial nucleus in caudal pons and the total number of CTB-labelled motor neuronal cell bodies were 270+/-29.3.
Animals ; Cholera Toxin* ; Cholera* ; Motor Neurons* ; Pons ; Rats* ; Trigeminal Nuclei

No abstract available.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis* ; Glioma* ; Pons*

OBJECTIVE: To compare dysphagia between infratentorial stroke patients and supratentorial stroke patients. METHODS: Subjects of this study were patients with post-stroke dysphagia (PSD) who were admitted to our medical institution between May 2014 and June 2017. We evaluated a total of 64 patients with PSD. A videofluoroscopic swallowing study (VFSS) was performed to determine dysphagia severity. We measured the following parameters: pharyngeal transit time (PTT), post-swallow pharyngeal remnant, Penetration Aspiration Scale (PAS) scores, and Functional Dysphagia Scale (FDS). We analyzed patient's results from VFSS performed at admission. All VFSS images were recorded using a camcorder running at 30 frames per second. An AutoCAD 2D screen was used to measure post-swallow pharyngeal remnant. RESULTS: In this study, PTT and FDS were similar (p>0.05) between infratentorial stroke patients and supratentorial stroke patients. However, there were significant differences in pharyngeal remnant and PAS scores between the two groups (p<0.01 and p<0.05, respectively). CONCLUSION: Both pharyngeal remnant and PAS score registered higher levels from VFSS test for infratentorial stroke patients than those for supratentorial stroke patients. This suggests greater chances of problems occurring with swallowing, the major functions of pons. Thus, clinicians should pay particular attention to active dysphagia evaluation and treatment in PSD of infratentorial stroke patients.
Deglutition ; Deglutition Disorders ; Fluoroscopy ; Humans ; Pons ; Running ; Stroke