双侧延髓内侧梗死临床与影像特点分析

Analysis of clinical and imaging characteristics of bilateral medial medullary infarction

目的探讨双侧延髓内侧梗死的临床及影像学特征。方法回顾性分析中国医科大学附属盛京医院收治的3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 3例患者均为男性,临床主要表现为四肢瘫痪、构音障碍、感觉异常,其中1例患者伴有呼吸衰竭。1例患者初期怀疑吉兰-巴雷综合征。"心"形、"Y"形及"V"形高信号为其典型的MRI扩散加权成像的影像特征。结论双侧延髓内侧梗死为临床少见的后循环缺血病变,早期症状不典型,容易误诊及漏诊。MRI扩散加权成像为其主要的影像学检查手段。

Objective To investigate the clinical and imaging characteristics of bilateral medial medullary infarction. Methods The clinical data of 3 patients with bilateral medial medullary infarction admitted to Shengjing Hospital of China Medical University were analyzed retrospectively. The related literature was reviewed. Results Three patients in this group were all males. Their main clinical manifestations were quadriplegia, dysarthria, and paresthesia, and 1 of them complicated with respiratory failure. One patient was suspected of having Guillain-Barre syndrome. The hyperintensities of ＆quot;heart-＆quot;shape,＆quot;Y-＆quot; shape,and ＆quot;V-＆quot; shape were its imaging features of typical MRI diffusion weighted imaging. Conclusion Bilateral medial medullary infarction is a rare posterior circulation ischemic lesion in clinical practice. Its early symptoms are not typical and easy to be misdiagnosed and missed. MRI diffusion weighted imaging is its main imaging examination method.