双侧延髓内侧梗死患者临床特点分析  

Clinical characteristics of 12 patients with bilateral medial medullary infarction

作　　者：常文广[1] 刘鹏[1] 高绚照[1] 

机构地区：[1]新乡市中心医院神经内科,453000

出　　处：《中华老年心脑血管病杂志》2015年第5期501-503,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的分析双侧延髓内侧梗死的临床特点,提高双侧延髓内侧梗死的早期诊断率。方法收集河南省新乡市中心医院神经内科住院的1例患者和国内报道的11例双侧延髓内侧梗死的临床资料,对12例患者临床资料进行分析。结果双侧延髓内侧梗死临床表现多样,多为急性起病或进行性加重的四肢无力,饮水呛咳、吞咽困难和构音障碍,深浅感觉异常,偏瘫,病情严重时可导致呼吸衰竭。其磁共振弥散加权成像系列影像学特征表现为,双侧延髓内侧高信号,类似"心型"外观。结论双侧延髓内侧梗死临床罕见,预后差,易误诊,对于四肢瘫患者,临床医师应密切观察病情演变,多开拓临床思路,尽早行头颅磁共振检查将有助于临床的诊断。Objective To improve the diagnosis of bilateral medial medullary infarction by analyzing its clinical characteristics. Methods Clinical data of 11 bilateral medial medullary infarction patients reported in China and 1 patient admitted to our department were retrospectively ana- lyzed. Results The clinical manifestations of bilateral medial medullary infarction patients varied, including acute onset or progressive qnadriplegia,drinking choking,tongue paresis,dysphagia and dysarthria,abnormal superficial and deep sensibility,and respiratory failure. MRI showed hyperintense signals in bilateral medulla with classical＂heart appearance＇sign. Conclusion bilateral me- dial medullary infarction is a rare stroke syndrome with a poor outcome and is easy to be misdiag- nosed. Clinicians should pay their close attention to those with tetraplegia. Early brain MRI con- tributes to its dianosis.

关 键 词：脑梗死 延髓 四肢麻痹 吞咽障碍 呼吸功能不全 磁共振成像 弥散 早期诊断 

分 类 号：R743.3[医药卫生—神经病学与精神病学]