A Rare Case of Isolated Left Medial Midbrain Stroke

Midbrain stroke is uncommon. We are presenting an interesting case of a patient with rare isolated left midbrain stroke. The patient had third cranial nerve palsy. Magnetic resonance imaging (MRI) brain showed acute stroke at the medial part of left midbrain. Magnetic resonance angiography (MRA) was normal.

Holmes tremor in the head and neck region caused by midbrain and thalamic hemorrhage:a case report

Objective:to describe the clinical fea-tures of Holmes tremor(HT)in the head and neck region caused by midbrain and thalamus hemorrhage.Methods:we collected the clinical history and examination data of a patient with HT in the head and neck region.Results:the patient had HT in the head and neck region with dizzi-ness.Brain computed to mography(CT)showed midbrain and thalamus hemorrhage.Conclusion:HT in the head and neck region as a delayed complication of midbrain and thalamus stroke are rare in clinic.When patients have a tremor in the head and neck region after midbrain or thalamus stroke,HT should be considered.

继发于中脑梗死的Wernekink连合综合征合并Holmes震颤一例并文献复习

中脑梗死引起Wernekink连合综合征较罕见,主要表现为双侧小脑功能障碍、构音障碍、核间性眼肌麻痹与软腭震颤,软腭震颤一般出现在恢复期。作者报道1例继发于中脑梗死的Wernekink连合综合征合并Holmes震颤患者,神经系统体格检查示构音障碍,左前核间性眼肌麻痹和双侧小脑功能障碍,头部MR显示左侧中脑被盖尾端亚急性腔隙性脑梗死,给予阿司匹林和氯吡格雷双重抗血小板聚集治疗及抗高血压病、抗糖尿病和他汀类药物二级预防,治疗15 d后,共济失调症状有所改善,出院当天患者出现较早的头部震颤,即Holmes震颤。作者系统检索相关文献并复习已报道的相关病例,总结临床特征,发现双侧小脑共济失调与构音障碍是Wernekink连合综合征的主要临床特点,核间性眼肌麻痹和软腭阵挛及Holmes震颤较常见。

不同方法对中脑导水管流畅性及大脑中动脉狭窄诊断分析

目的对比3D-TOF-MRA与3D-CE-MRA对缺血性脑卒中中脑导水管流畅性和大脑中动脉狭窄的诊断效果。方法选择缺血性脑卒中患者172例,均行3D-TOF-MRA与3D-CE-MRA检查,观察患者中脑导水管流畅性、大脑中动脉狭窄情况与大脑中动脉M1段、M2段及M3段的血管成像效果。结果 3D-TOF-MRA与3D-CE-MRA对中脑导水管流畅性评定效果无显著差异(P> 0.05),多数为可能不流畅与可能流畅。3D-CE-MRA诊断大脑中动脉闭塞者22例,重度狭窄者18例,中度狭窄者20例,轻度狭窄者26例,无狭窄者86例;3D-TOF-MRA诊断闭塞者28例,重度狭窄者22例,中度狭窄者20例,轻度狭窄者25例,无狭窄者77例,两组比较无显著差异(P> 0.05)。两种方法对大脑中动脉M1段显示无统计学差异,但3D-CE-MRA对M2、M3段血管成像优者比例明显高于3D-TOF-MRA(P <0.05)。结论 3D-TOF-MRA与3D-CE-MRA均可用于缺血性卒中患者中脑导水管流畅性及大脑中动脉狭窄程度的诊断,但3D-CE-MRA对大脑中动脉M2及M3段的血管成像效果优于3D-TOF-MRA。