Medial medullary stroke: Report of seven patients and review of the literature
Medial medullary stroke: Report of seven patients and review of the literature
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DOI：
10.1212/wnl.48.4.882
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发表时间：
1997-04-01
期刊：
影响因子：
9.9
通讯作者：
Bernasconi, A
中科院分区：
文献类型：
--
作者：
Bassetti, C;Bogousslavsky, J;Bernasconi, A
内髓质梗死（MMI）报告在不到40例患者满意的临床地形文件。我们研究了7例mri证实的急性MMI患者，于5年期间（1990-1994）在两个神经科就诊。MMI占后循环缺血性卒中的不到1%。5例患者在锥体上方发生梗死。所有患者均有对侧偏瘫和肢体感觉丧失，其中3例伴有同侧舌麻痹（Dejerine综合征）。2例患者锥体以下脑梗死，伴同侧偏瘫和肢体感觉丧失。MMI的伴随症状和体征为眩晕和恶心（n = 5），轻度单侧或对侧疼痛感觉减少（n = 6），头痛（n = 4），同侧肢体共济失调（n = 6），对侧躯干侧脱（n = 5），轻度同侧上睑下垂（n = 4），眼球震颤（n = 4），构音障碍（n = 3）和嗜睡（n = 2）。推测MMI的原因是同侧椎动脉狭窄、闭塞或剥离（n = 5）和心脏栓塞（n = 1）。5例患者在3个月时预后良好。总之，MMI的临床特征比通常认为的更加多样化，而其病因似乎相当稳定（椎动脉疾病）。
Medial medullary infarctions (MMI) were reported in less than 40 patients with satisfactory clinico-topographic documentation. We studied seven patients with MRI-proven acute MMI seen in two neurologic departments over a 5-year period (1990-1994). MMI represented less than 1% of ischemic strokes in the posterior circulation. Five patients had an infarction above the pyramidal decussation. All patients had contralateral hemiparesis and lemniscal sensory loss, accompanied by ipsilateral lingual palsy (Dejerine's syndrome) in three. Two patients had infarction below the pyramidal decussation, with ipsilateral hemiparesis and lemniscal sensory loss. Accompanying symptoms and signs of MMI were vertigo and nausea (n = 5), mild ipsi- or contralateral decrease in pain sensation (n = 6), headache (n = 4), ipsilateral limb ataxia (n = 6), contralateral truncal lateropulsion (n = 5), mild ipsilateral ptosis (n = 4), nystagmus (n = 4), dysarthria (n = 3), and somnolence (n = 2). Presumed causes of MMI were stenosis, occlusion or dissection of the ipsilateral vertebral artery (n = 5), and cardioembolism (n = 1). Outcome at 3 months was favorable in five patients. In conclusion, the clinical features of MMI are more heterogeneous than commonly thought, whereas its etiology seems fairly constant (vertebral artery disease).