延髓梗死的临床与神经影像学分析(附73例报告)  

Clinical and neuroimaging analyses of medullary infarction in 73 cases

作　　者：孙庆华[1,2] 徐林麟 尹琳[1] 

机构地区：[1]大连医科大学附属第二医院神经内科,辽宁大连116027 [2]大连市中山区人民医院神经内科,辽宁大连116021

出　　处：《中风与神经疾病杂志》2016年第10期923-926,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨延髓梗死的临床与神经影像学特点。方法回顾性分析73例延髓梗死患者的临床资料和影像学检查结果。结果本组男性53例,女性20例。首发临床表现复杂多样,其中浅感觉障碍41例,眩晕39例,饮水呛咳36例,恶心呕吐32例,吞咽困难31例,构音障碍29例。梗死病灶位于延髓上段27例,中段29例,下段12例,同时累及上段和中段3例,中段和下段2例。病灶位于背外侧61例,腹内侧10例,背内侧2例。表现为经典的延髓综合征共15例,包括Wallenberg综合征12例,Dejerine综合征1例,Avellis综合征1例,Babinski-Nageotte综合征1例。结论延髓梗死常见临床表现是浅感觉障碍和后循环缺血症状,经典延髓综合征少见;延髓梗死以中上段最常见,主要发生于背外侧;头部MRI对延髓梗死的诊断有极其重要的意义。Objective To investigate clinical and neuroimaging features of medullary infarction .Methods Clinical characteristics and imaging document in 73 patients with medullary infarction were analyzed retrospectively .Results A-mong 73 cases,53 were male and 20 were female.Primary clinical manifestations of casrs with medullary infarction were complex and diverse,including such most common signs as superficial sensory disturbance in 41 cases,dizziness in 39 ca-ses,regurgitation in 36 cases,nausea or vomiting in 32 cases,dysphagia in 31 cases and dysarthria in 29 cases.Ischemic le-sions were found in the upper ,middle,lower,both upper and middle ,as well as both middle and lower segments of medulla oblongata in 27,29,12,3,and 2 cases,respectively.Only 15 cases presented classical medullary syndromes including Wal-lenberg syndrome in 12 cases,Dejerine syndrome in 1 case,Avellis syndrome in 1 case and Babinski-Nageotte syndrome in 1 case.Conclusions The most common clinical manifestations of medullary infarction are superficial sensory disturbance and ischemic symptoms of the post circulation .Classical medullary syndromes are relatively infrequent .Ischemic lesion is most commonly found in the middle and upper segments of medulla oblongata ,mainly in the dorsal lateral aspect .Brain MRI examination plays a significant role in the diagnosis of medullary infarction .

关 键 词：延髓梗死 临床特点 影像学 延髓综合征 

分 类 号：R743.3[医药卫生—神经病学与精神病学]