Basilar Artery Atherosclerosis and Hypertensive Small Vessel Disease in Isolated Pontine Infarctions: A Study Based on High-Resolution MRI

<b><i>Background:</i></b> Isolated pontine infarctions are classified as paramedian pontine infarction (PPI) and lacunar pontine infarction (LPI), usually attributed to basilar artery (BA) atherosclerosis and small vessel disease (SVD), respectively. Recently, researchers found BA atherosclerotic plaques in LPI and made the pathogenesis of LPI confusing. <b><i>Methods:</i></b> We evaluated the presence and location of BA plaques with high-resolution MRI and SVD burden with presence of hypertension, leukoaraiosis and silent brain infarction. <b><i>Results:</i></b> The prevalence of BA plaques and SVD was similar between PPI and LPI, with most plaques relevant to corresponding infarctions. Some PPI had no plaques; some LPI had no obvious SVD. <b><i>Conclusion:</i></b> SVD and BA plaques with or without lumen stenosis were both possible causes of PPI and LPI.