Mechanism of medullary infarction based on arterial territory involvement.
Mechanism of medullary infarction based on arterial territory involvement.
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DOI：
10.3988/jcn.2012.8.2.116
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发表时间：
2012-06
期刊：
影响因子：
--
通讯作者：
Heo JH
中科院分区：
文献类型：
--
作者：
Kim K;Lee HS;Jung YH;Kim YD;Nam HS;Nam CM;Kim SM;Heo JH
延髓的血液供应与脑干其他区域的血液供应不同，因此延髓梗死的机制可能不同。然而，很少有研究对此进行调查。在1999年2月至2008年4月期间纳入卒中登记的3833例卒中患者中，纳入了弥散加权磁共振成像证实的髓梗死患者。我们分析了病变的地形、累及的动脉区域和病因机制。共有142例患者入组研究。双侧髓质梗死罕见（2.2%）。病变涉及前内侧或外侧领域是常见的延髓上部，而外侧领域的参与是常见的延髓的中部和下部区域。椎动脉明显狭窄（>50%）或闭塞常见（52.2%）。在中风亚型中，大动脉粥样硬化最常见（34.5%），而腔隙和心源性栓塞则很少见（分别为3.5%和4.2%）。椎动脉夹层是常见的。卒中机制因涉及的血管区域而异。大动脉粥样硬化在外侧、前内侧和后区产生病变。心源性栓塞或其他病因均不涉及前内侧或前外侧区域，但均涉及外侧和/或后部区域。腔隙性梗死仅见于前内侧和前外侧区域。累及延髓的梗死部位和机制因累及的动脉区域不同而不同。这些发现可能与延髓动脉供应的独特模式有关。
The blood supply to the medulla oblongata is distinct from that of other areas of the brainstem, and thus the mechanism underlying medullary infarctions may be distinct. However, few studies have investigated this. Of 3833 stroke patients who were on the stroke registry between February 1999 and April 2008, those with medullary infarctions demonstrated on diffusion-weighted magnetic resonance imaging were enrolled. We analyzed the topography, the involved arterial territories, and the etiologic mechanisms of the lesions. In total, 142 patients were enrolled in the study. Bilateral medullary infarctions were rare (2.2%). Lesions involving the anteromedial or lateral territories were common in the upper medulla oblongata, whereas lateral territorial involvements were common in the middle and lower regions of the medulla oblongata. Significant stenosis (>50%) or occlusion of the vertebral artery was common (52.2%). Among stroke subtypes, large-artery atherosclerosis was most common (34.5%), while lacunae and cardioembolism were rare (3.5% and 4.2%, respectively). Vertebral artery dissection was frequent. The stroke mechanisms differed with the involved vascular territories. Large-artery atherosclerosis produced lesions in the lateral, anteromedial, and posterior territories. None of the cardioembolisms or other etiologies involved anteromedial or anterolateral territories, but all involved the lateral and/or posterior territories. Lacunar infarction was found only in the anteromedial and anterolateral territories. The topography and mechanisms of infarctions involving the medulla oblongata are different with the involved arterial territories. These findings may be associated with the distinct pattern of arterial supply to the medulla oblongata.
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影响因子：
11
作者：
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