Ege University

About: Ege University is a education organization based out in Izmir, Turkey. It is known for research contribution in the topics: Population & Medicine. The organization has 10166 authors who have published 22035 publications receiving 429516 citations.

Clinical spectrum of pontine infarction

Abstract: We sought clinical and radiological findings of 150 consecutive patients with acute isolated pontine infarct who were admitted to our Stroke Unit over 6 years. In all patients CT, MRI and magnetic resonance angiography (MRA) were performed during the hospitalization. On clinico-radiological analysis regarding the pontine lesion boundaries there were five main clinical patterns that depended on the constant territories of intrinsic pontine arteries: (1) anteromedial pontine syndrome (58 %) presented with motor deficit with dysarthria, ataxia, and mild tegmental signs in one third of patients; (2) anterolateral pontine syndrome (17 %) developed with motor and sensory deficits in half of the patients, and were associated with tegmental signs (56 %) more frequently than the anteromedial infarct syndrome; (3) tegmental pontine syndrome (10 %) presented with mild motor deficits and associated with sensory syndromes, eye movement disorders and vestibular system symptoms including vertigo, dizziness and ataxia; (4) bilateral pontine syndrome (11 %) consisted with transient consciousness loss, tetraparesis and acute pseudobulbar palsy; (5) unilateral multiple pontine infarcts (4 %) were rarely observed, and were always associated with severe sensory-motor deficits and tegmental signs. In our series, there was no infarct in the extreme dorsal and lateral tegmental pontine territories which have been mostly associated with cerebellar infarctions. The main etiology of stroke was basilar artery branch disease (BABD) in 59 patients (39 %), followed by small-artery disease (SAD) in 31 (21 %), large-artery disease of vertebrobasilar arteries in 27 patients (18 %), cardioembolism in 12 (8 %) and in 16 patients (11 %) no cause of stroke was found. Our findings suggest that it is possible to identify clinical subgroups of pontine infarction, in which BABD and SAD were the most common causes of stroke. After an acute onset, outcome is in general excellent except in those with bilateral pontine lesions.

Dysphagia in Lateral Medullary Infarction (Wallenberg’s Syndrome) An Acute Disconnection Syndrome in Premotor Neurons Related to Swallowing Activity?

Abstract: Background and Purpose— We have investigated the pathophysiological mechanisms of dysphagia in Wallenberg’s syndrome (WS) that are due to lateral medullary infarction (LMI). Methods— Twenty patients with WS were evaluated by means of clinical and electrophysiological methods that measured the oropharyngeal phase of voluntarily initiated swallowing. For comparison, 22 patients with unilateral hemispheric infarction were investigated during the acute stage of stroke, and 4 patients with unilateral peripheral 9th and 10th cranial nerve palsies were studied. Age-matched 30 healthy control subjects were also included in the study. Results— It was found that dysphagia was clinically more severe in WS patients than in the patients in the other groups. The pharyngeal phase of swallowing was predominantly impaired, whereas in patients with hemispheric stroke, dysphagia was related only to the delay of triggering of the voluntarily induced swallowing. In WS patients, the swallowing reflex was extremely slow in spit...