Clinical and imaging characteristics of bilateral medial medullary infarction in elderly patients
10.3760/cma.j.issn.0254-9026.2019.03.008
- VernacularTitle:老年双侧延髓内侧梗死患者临床及影像学分析
- Author:
Xuemei WANG
1
;
Yanling WANG
;
Yijie SHI
;
Hongpeng ZHANG
;
Qiling JI
;
Xiaokun GENG
;
Huishan DU
Author Information
1. 首都医科大学附属北京潞河医院神经内科 101149
- Keywords:
Bilateral medial medullary infarction;
Magnetic resonance imaging
- From:
Chinese Journal of Geriatrics
2019;38(3):255-259
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of bilateral medial medullary infarction (BMMI)in elderly patients.Methods Clinical and imaging data of 8 elderly BMMI patients with different morphology on diffusion-weighted magnetic resonance imaging (DWI-MR) were retrospectively analyzed.All patients were diagnosed by MRI,while 4 patients received CTA and vascular ultrasound testing,and the other 4 patients received vascular ultrasound testing.Results All 8 cases(100.0％) had acute-onset BMMI.Patients showed varying degrees of acroparalysis(7/8,87.5 ％),dizziness (5/8,62.5 ％),dysarthria(6/8,80.0 ％),dysphagia(3/8,37.5 ％),deep or superficial sensory dysfunction(5/8,62.5 ％),consciousness disorders (2/8,25.0 ％),dyspnea (2/8,25.0 ％),and tinnitus(1/8,12.5 ％).Lesions in most patients were located in the upper part of medulla oblongata(7/8,87.5 ％).In the transverse direction of DWI,the lesions as the inverted V shape were seen in 3 cases (37.5％),the V shape(12.5％)in 1 case,the Y shape(37.5％)in 3 cases,and the heart shape(12.5％) in 1 case.All 8 patients were complicated with posterior cerebral artery stenosis or occlusion,of whom patients with heart-or Y-shaped lesions showed progressive exacerbation.After treatment,4 cases (50.0 ％) recovered,3 cases (37.5 ％) improved,and 1 case (12.5 ％) unrecovered before discharge from the hospital.Conclusions Most elderly BMMI patients have concurrent posterior circulation artery stenosis,and patients with heart-or Y-shaped lesions on MR-DWI show rapid progression and have a poor prognosis.Cranial examination with MR-DWI is helpful for early clinical diagnosis of BMMI,prediction of disease progression and effective prevention of complications.
