双侧延髓内侧梗死二例临床和影像学分析
Clinical and radiological analysis of two cases with bilateral medial medullary infarction
张秀丽 1张美娇 1刁剑霞 1谭晓天 2王剑锋1
作者信息
- 1. 116033 大连医科大学附属大连市中心医院神经内二科
- 2. 116033 大连医科大学附属大连市中心医院影像科
- 折叠
摘要
目的 探讨双侧延髓内侧梗死的临床表现、病因、MRI特点及预后.方法 总结2例双侧延髓内侧梗死患者的临床资料并复习相关文献.结果 2例患者在临床上表现为进展性四肢瘫痪,均累及呼吸；病因均为动脉粥样硬化所致,同时1例合并先天血管变异；影像学上,MRI弥散加权成像(DWI)显示延髓水平“Y”字型的高信号影；预后差,1例死亡,1例气管切开并遗留严重后遗症.结论 双侧延髓内侧梗死症状复杂多样,以四肢瘫痪为主要特点,可合并舌下瘫、构音障碍,严重者引起呼吸衰竭,DWI可表现为特征性“Y”字型改变,预后不佳.
Abstract
Objective To study the clinical manifestations,etiology,magnetic resonance imaging features,prognosis of patients with bilateral medial medullary infarction.Methods The clinical information of two case reports were summarized with review of the literature.Results The 2 patients with bilateral medial medullary infarction reported here were manifested with progressive quadriplegia,both complicated with respiratory disorders.On etiology,both were due to atherosclerosis,and one was combined with congenital vascular variation.The "Y shaped" hyperintense signals were seen in diffusion weighted imaging (DWI) cross-section in the medulla oblongata level.And both had poor outcomes that one was dead and the other was discharged with tracheotomy and severe sequela.Conclusions Bilateral medial medullary infarction is presented with complicated symptoms such as quadriplegia,dysarthria,hypoglossoplegia,even respiratory failure,in which quadriplegia is most often seen,and it is associated with a poor clinical prognosis.DWI appears the characteristic "Y Shaped" sign.
关键词
大脑梗死/磁共振成像,弥散/预后Key words
Cerebral infarction/Diffusion magnetic resonance imaging/Prognosis引用本文复制引用
出版年
2013
NETL
NSTL
维普
万方数据