Progressive stroke in pontine infarction

Objective –  The pathogenesis of isolated pontine infarctions is still unclear, being attributed both to small or large vessel disease. The extension of infarcted tissue to the pons surface has been indicated as a possible marker of basilar branch atheromatous disease and some neuroimaging evidence confirms this finding. Methods –  On the basis of Kim’s et al., study, we performed a revision of the literature addressing this topic. Results –  Several authors confirm an association between basilar artery branch disease and isolated pontine infarction; moreover, the enlargement of pontine lesion seems to be associated with neurological worsening. We therefore performed a brief analysis of possible mechanisms of progression. Conclusions –  Prospective studies could be useful to evaluate predictors of neurological worsening in pontine stroke. Improvement of neuroimaging techniques is needed for a deeper comprehension of the etiopathogenesis of isolated pontine infarction.