Abstract
Background: So far, the diagnosis of acute AOP infarction is uncommon. The purpose of our study was to characterize the relationship between the imaging spectrum of acute AOP infarction and its clinical manifestations and prognosis on the basis of 23 cases.Methods: A total of 23 patients with acute AOP infarction in our institution from 2014 to 2019 were reviewed retrospectively. All cases were evaluated with computed tomography (CT), magnetic resonance imaging (MRI), detailed clinical and evaluated prognosis used a modified Rankin scale (mRs), blood studies, electrocardiogram and transthoracic echocardiography. All standard risk factors were recorded in these patients. mRs scores 90 days after discharge. Results: We identified 4 various patterns of acute AOP infarction: (1) bilateral paramedian thalamic infarction (BPTI, 52%), (2) bilateral paramedian thalamic with rostral midbrain infarction (BPTRMI, 30%), (3) bilateral paramedian and anterior thalamic infarction (BPATI, 13%), and (4) bilateral paramedian thalamic with red nuclei infarction (BPTRNI, 4%). These patients had consciousness disorder, memory dysfunctions, vertical gaze paresis, mesencephalothalamic syndrome and so on. The 65% patients with BPTI and BPATI who experienced a good functional recovery and could carry out daily life activities (mRS score ≤ 2). However, patients with BPTRMI who have an unfavorable outcome.Conclusion: Although the clinical feature of patients with AOP infarction is variable, DWI or ADC map can improve the diagnosis of acute AOP infarction patterns. Acute AOP occlusion requires immediate diagnosis and treatment initiation for a more favorable outcome and additional unnecessary procedures.