Background: We aimed to investigate the association between early neurological deterioration (END) and hypoplasia of posterior communicating arteries (h-pCoA) in patients with atherosclerotic pontin infarcts. 
Methods: Patients with acute pontine infarct attributed to atherosclerotic stenosis of basilar artery (≥30%) were identified based on clinical information, DWI-MRI and CT-Angiography findings.  END was defined as ≥2 unites increase on initial NIHSS scores without any apparent cause of extracerebral illness in the first 5 days of presentation. The h-pCoA was diagnosed if pCoA diameter <1 mm or it was completely absent. Univariate and multivariate analysis were used to determine the association between END and the presence of h-pCoA. 
Results: Of 85 patients (mean age 65.5±11.3, mean NIHSS 5.7±3.3) included into the study, 22 (25.9%) exhibited END. Age, sex, vascular risk factors and initial NIHSS scores were not different between groups with and without END (p>0.2 for all comparisons). 42 (49.4%) patients had at least one h-pCoA and 13 (15.3%) had bilateral h-pCoA. END was significantly higher in patients having h-pCoA bilaterally and was mathematically higher in patients with at least one h-pCoA as compared to patients without any h-pCoA (p=0.033, p=0.143, respectively). In multivariate models, END was found to be marginally associated with the presence of bilateral h-pCoA (p:0.070, odd’s ratio: 3.62, 95% confidence interval: 0.90-14.5). 
Conclusion:  Our results suggest that patients with atherosclerotic pontine infarct having poor pCoA collaterals might be at high risk for END and the status of pCoA should be identified in order to predict END in those patients.

The Association of Posterior Communicating Artery Hypoplasia with Early Neurological Deterioration in Atherosclerotic Pontine Infarcts