Krasnianski Michael, Neudecker Stephan, Schluter Andreas, Zierz Stephan
Neurologische Klinik, Martin-Luther-Universität, Halle-Wittenberg, Ernst-Grube-Str. 40, 06097 Halle (Saale), Germany.
J Neurol. 2003 Aug;250(8):938-42. doi: 10.1007/s00415-003-1118-9.
A hemimedullary infarction, in which medial and lateral medullary lesions occur simultaneously, is a rare cerebrovascular disease. It has been suggested that the Babinski-Nageotte's syndrome is the classical brainstem syndrome that corresponds to hemimedullary lesion. In this study we compare clinical symptoms and magnetic resonance imaging (MRI) data of two patients exhibiting classical Babinski-Nageotte's syndrome according to the original description with symptoms and MRI data of a patient with clinically complete hemimedullary lesion. Our study shows that Babinski-Nageotte's syndrome is neither clinically nor on MRI identical with hemimedullary lesion. Hypoglossal palsy, an invariable symptom of hemimedullary syndrome, is not part of the Babinski-Nageotte's syndrome according to the original description. Consistent with the original historical report, Babinski- Nageotte's syndrome is a lateral "Wallenbergian" medullary lesion with a spreading of the lesion to the more basal localised pyramidal tract. The clinical features of the hemimedullary syndrome, described in 1894 by Reinhold, and the MRI appearances in our patient with this syndrome are clearly different from other classical brainstem syndromes and should be called Reinhold's syndrome.
半侧延髓梗死是一种罕见的脑血管疾病,其中内侧和外侧延髓病变同时发生。有人提出,巴宾斯基-纳热奥特综合征是与半侧延髓病变相对应的经典脑干综合征。在本研究中,我们将两名根据原始描述表现出经典巴宾斯基-纳热奥特综合征的患者的临床症状和磁共振成像(MRI)数据与一名临床上完全性半侧延髓病变患者的症状和MRI数据进行了比较。我们的研究表明,巴宾斯基-纳热奥特综合征在临床和MRI上均与半侧延髓病变不同。舌下神经麻痹是半侧延髓综合征的一个恒定症状,但根据原始描述,它并不是巴宾斯基-纳热奥特综合征的一部分。与原始历史报告一致,巴宾斯基-纳热奥特综合征是一种外侧“瓦伦贝格氏”延髓病变,病变扩散至更低位的锥体束。1894年由莱因霍尔德描述的半侧延髓综合征的临床特征以及我们患有该综合征患者的MRI表现与其他经典脑干综合征明显不同,应称为莱因霍尔德综合征。