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(Stroke. 2002;33:925.)
© 2002 American Heart Association, Inc.

Original Contributions

Hypertensive Pontine Microhemorrhage

Jee-Hyang Jeong, MD; Soo Jin Yoon, MD; Sue J. Kang, MS; Kyung Gyu Choi, MD Duk L. Na, MD

From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (J.-H.J., S.J.K., D.L.N.); Department of Neurology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea (S.J.Y.); and Department of Neurology, Mokdong Hospital, Ewha Woman’s University School of Medicine, Seoul, Korea (K.G.C.).

Correspondence to Dr Duk L. Na, Department of Neurology, Sungkyunkwan University, Samsung Medical Center, 50 Ilwon-Dong, Kangnam-Ku, Seoul, 135-710 Korea. E-mail dukna{at}smc.samsung.co.kr

Background and Purpose— This study investigated whether the topography of hypertensive pontine microhemorrhages (hPMHs) resembles that of larger primary pontine hemorrhages.

Methods— Sixty-nine consecutive patients with small-vessel disease underwent imaging with gradient-echo MRI, and 27 patients with hPMH were detected. Lesion size and location along the rostrocaudal (longitudinal), lateral (coronal), and anteroposterior (sagittal) axes were determined.

Results— A total of 52 hPMHs were identified in the 27 patients (mean, 1.93±2.4 per patient). The lesions showed a nonrandom distribution, with a propensity to occur in the middle pons in the rostrocaudal axis, posterior half of the basis pontis in the anteroposterior axis, and central subdivision within the lateral axis. The area of hPMH ranged from 1.3 to 19.0 mm² (mean, 5.06±3.72 mm²). The size of hPMH did not vary as a function of lesion location.

Conclusions— Previous studies reported that primary pontine hemorrhages tend to occur in the middle pons and at the junction of basis pontis and tegmentum. Therefore, topographical correspondences between large and small pontine hemorrhages may provide evidence that the 2 lesions share some etiological basis. Further investigation may determine whether hPMHs portend future symptomatic primary pontine hemorrhages.

Key Words: dementia, vascular • intracranial hemorrhages • magnetic resonance imaging • small-vessel disease

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