TOAST classification of isolated pontine infarction

Abstract

Background Through the analysis of various imaging and angiography data, including computed tomography angiography (CTA), magnetic resonance angiography (MRA) and digital subtraction angiography (DSA), this article aims to understand the relation between pontine infarction and posterior circulation lesions, classify different types of causes of isolated pontine infarction, and compare the clinical characteristics of different classification methods. Methods Eighty-five cases with first-onset isolated pontine infarction were selected. On the basis of imaging examinations, they were divided into the following categories: vertebrobasilar large-artery disease (VLAD); basal artery branch disease (BABD); small artery disease (SAD); type of other reasons and type of uncertain causes. According to Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification standard, all patients were divided into the following categories: large artery atherosclerosis (LAA), small artery occlusion (SAO), cardiac embolism (CE), stroke of other determined etiology (SOE), stroke of undetermined etiology (SUE). Results According to imaging classification, BABD was the most common type, accounting for 50.59% (43/85); SAD accounted for 28.23% (24/85); VLAD accounted for 14.12% (12/85); type of uncertain causes accounted for 7.06% (6/85); type of other reasons was not found. Based on the TOAST classification, SAO was the most common type, accounting for 67.06% (57/85); LAA accounted for 30.59% (26/85); SUE accounted for 2.35% (2/85); CE and SOE were not found. Conclusion Based on the TOAST classification, small artery occlusion is the most common etiology of isolated pontine infarction. It is favorable for formulating specific treatment to make TOAST classification based on a variety of imaging data.