34例外侧延髓梗死患者临床及头颅MRI/MRA特征分析

Clinical characteristics and head MRI/MRA characteristics in 34 patients with lateral medullary infarction

目的分析34例外侧延髓梗死(LMI)患者的临床特征及头颅MRI/MRA特征。方法选取2017-01—2021-12青岛市市立医院收治的34例LMI患者,分析其临床表现及影像学特征。结果34例患者临床表现以头晕/头痛(29例,85.29%)、恶心呕吐(24例,70.59%)、浅感觉障碍例(20例,58.82%)、共济失调(24例,70.59%)、运动无力(15例,44.12%)为主,符合典型外侧延髓梗死临床特征。MRI检查均可见外侧延髓梗死,其中在水平层面,病灶部位在左侧20例(58.82%),右侧14例(41.18%);自头端至尾端,病灶位于上段5例(14.71%),中段12例(35.29%),下段15例(44.12%),中下段2例(5.88%)。颅脑和颈动脉MRA检查可见脑动脉硬化14例(41.18%)。结论LMI临床表现多不典型,以头晕/头痛、恶心呕吐、浅感觉障碍及共济失调为主,病灶多集中在中、下段,动脉粥样硬化是其常见病因,诊断主要依据临床特征及MRI检查。

Objective To analyze the clinical characteristics and head magnetic resonance imaging/MR angiography(MRI/MRA)characteristics in 34 patients with lateral medullary infarction(LMI).Methods A total of 34 patients with LMI admitted to Qingdao Municipal Hospital were enrolled between January 2017 and December 2021,their clinical manifestations and imaging characteristics were analyzed.Results In the 34 patients,there were 29(85.29%)cases with dizziness/headache,24(70.59%)cases with nausea and vomiting,20(58.82%)cases with superficial sensory disturbance,24(70.59%)cases with ataxia and 15(44.12%)cases with motor weakness,which were consistent with typical clinical characteristics of LMI.MRI showed lateral medullary infarc⁃tion.In the horizontal level,there were 20(58.82%)cases with left lesions 14(41.18%)cases with right lesions.From head end to the tail end,there were 5(14.71%)cases with lesions located in upper segment,12(35.29%)cases in middle segment,15(44.12%)cases in lower segment and 2(5.88%)cases in the middle and lower seg⁃ment.Craniocerebral and carotid artery MRA showed that there were 14(41.18%)cases with cerebral arterioscle⁃rosis.Conclusion The clinical manifestations of most LMI are atypical,which mainly include dizziness/headache,nausea and vomiting,superficial sensory disturbance and ataxia.LMI lesions are mainly located in middle and lower segments.Atherosclerosis is a common cause of LMI,and LMI diagnosis is mainly based on clinical characteris⁃tics and MRI.