BASILAR BRANCH DISEASE PRESENTING WITH PROGRESSIVE PURE MOTOR STROKE

Objectives - Isolated infarcts of the pens cause well definable neurol ogical syndromes with distinct pathomechanism, clinical course and pro gnosis. Patients and results - We report 8 cases suffering from a pure motor hemiparesis that was severely progressive within the 1st 3 days and unresponsive to aspirin. A relatively good recovery was observed in all patients, however, stroke recurrence occurred in 2 cases within 3 months and resulted in pseudobulbar paralysis and tetraparesis, MRT . displayed unilateral (n=6) and bilateral (n=2) ventromedial pontine infarctions (VPI). Angiographic evaluation (n=4) or color Duplex exami nation (n=4) revealed atherosclerotic lesions but no basilar artery oc clusion. Conclusion - Although VPI due to basilar branch disease may c linically mimic a classical lacunar syndrome, it is related to a parti cular pathogenetic mechanism different from microangiopathy or embolis m, In contrast to the MRI feature of lacunes, VPI typically extend to the basal surface of the pens. The progressive pattern, ending up in a relative uniform clinical picture, is probably caused by propagating thrombosis.