| 王昌林
，何丹
，陈红兵.延髓内侧梗死7例临床特点及影像学特征分析[J].神经损伤功能重建,2018,13(4):181-183 |
| 延髓内侧梗死7例临床特点及影像学特征分析 |
| Clinical Features and Imaging Features of 7 Cases of Medial Medullary Infarction |
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| DOI： |
| 中文关键词: 延髓内侧 脑梗死 |
| 英文关键词: medial medullary cerebral infarction |
| 基金项目:国家自然科学基金
（No. 8167050067） |
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| 中文摘要: |
| 目的：探讨延髓内侧梗死（MMI）患者的临床特点及影像学特征，以提高对此病的认识。方法：收集本
科收治的确诊为MMI的7例患者的临床资料，回顾性总结分析其临床表现、影像学特征并复习相关文献。
结果：7例患者平均发病年龄为（59±0.7）岁，男女比例为5∶2，平均发病时间（5.6±0.5）d。均为急性病程，主要
临床表现为头晕、言语不清、肢体无力和肢体感觉麻木，2例患者有嗜睡症状，1例患者进展性加重。所有患
者磁共振弥散加权成像（DWI）序列上显示延髓内侧高信号，其中2例诊断为双侧MMI，1例合并有新发枕叶
梗死。5例患者行磁共振血管成像（MRA）检查发现存在椎动脉局部狭窄或闭塞。结论：MMI临床表现复杂
多样，尤其双侧延髓内侧更加罕见。典型临床表现为突发起病的肢体瘫痪（双侧MMI会出现四肢瘫痪），同
时常伴有迷走神经、舌下神经损伤症状。尽早完善头颅磁共振等影像学检查，有利于早期本病的诊治。 |
| 英文摘要: |
| The purpose of this study was to explore the clinical features and imaging features of
patients with medial medullary infarction（MMI）. Methods: Clinical data from 7 patients diagnosed with MMI
was collected; clinical and radiological features were retrospectively analyzed, and related literature was
reviewed. Results: The average age of onset in 7 patients was (59±0.7）years, and the ratio of males to females
was 5∶2. The average onset period was (5.6±0.5）days. All patients presented cases of acute disease. The main
clinical manifestations were dizziness, unclear speech, and weakness and numbness of limbs. There were 2
patients with narcolepsy and 1 patient with progressive aggravation. Diffusion-weighted magnetic resonance
imaging（DWI）was performed on all patients to display high signal in the medial medulla. Two patients were
diagnosed with bilateral intramedullary infarction, and 1 case showed a new occipital infarction. Magnetic
resonance angiography （MRA） found localized stenosis or occlusion of vertebral artery in 5 patients.
Conclusion: The clinical manifestation of MMI is complicated and varied and is especially rare in the bilateral
medulla. Typical clinical manifestation is paralysis of the limbs with sudden onset of disease（both limbs display
paralysis in bilateral MMI）, often accompanied by vagal nerve and hypoglossal nerve injury. Obtaining brain
MRI and similar imaging results as soon as possible is helpful to improving the diagnosis and treatment of early
diseases. |
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