Objective   To investigate the clinical features, etiology and outcomes of acute pontine infarction patients with imaging manifestation as "pontine hemisection sign".

  Methods   Clinical materials of 11 acute pontine infarction patients with imaging manifestation as "pontine hemisection sign" were collected, and their clinical manifestations, imaging features, etiology and outcomes were retrospectively analyzed based on literature review.

  Results   The morphology of magnetic resonance imaging (MRI) in 11 patients with acute pontine infarction showed "pontine hemisection sign". All the patients were acute onset, with an average age of (72.64±8.26) years old, and the main risk factors were hypertension, diabetes and hyperlipidemia. The clinical symptoms of 11 patients were contralateral limb paralysis and dysarthria, accompanied by contralateral hemiparesis in 5 cases, central facial paralysis in 8 cases, central lingual paralysis in 7 cases, vertigo or dizziness in 5 cases, nystagmus in 4 cases and ataxia in 3 cases. The mean National Institutes of Health Stroke Scale (NIHSS) score of 11 patients at discharge was (4.91±2.54) points. MRI examination of all patients showed that the lesions involved the ventral, medial and medial areas of pons, of which 3 cases involved the anterolateral area. Severe stenosis or occlusion of vertebrobasilar artery was found in 3 patients by magnetic resonance angiography (MRA).

  Conclusion   "Pontine hemisection sign" is a special imaging sign of acute pontine infarction, the typical clinical manifestations are sudden onset contralateral limb paralysis, dysarthria and central facial paralysis, which can be accompanied by symptoms such as vertigo and nystagmus. Its main etiological mechanism is basilar artery branch degeneration and large artery occlusive disease, and most patients have a good clinical prognosis.