Lee C C, Ryu S J
Department of Neurology, China Medical College and College Hospital, Taichung, Taiwan, R.O.C.
J Formos Med Assoc. 1992 May;91(5):552-4.
A 40-year-old normotensive man suddenly developed dizziness, vomiting, hoarseness and swallowing disturbance. Neurologic examinations showed bilaterally decreased palatal elevation and gag reflex, upbeat nystagmus and gait ataxia. The diagnosis of medullary hemorrhage was first established by computed tomography (CT). Magnetic resonance imaging study further showed a hematoma in the paramedial medulla oblongata extending dorsorostrally to the pontomedullary junction. It gave the precise anatomic boundary of the intramedullary hematoma and was well correlated with the clinical findings. This patient's subsequent prognosis was good with gradual improvement of the clinical signs and symptoms. A follow-up CT scan showed resolution of the hematoma, and the prognosis was consistent with a good neurologic recovery.
一名40岁血压正常的男性突然出现头晕、呕吐、声音嘶哑和吞咽障碍。神经系统检查显示双侧腭部抬高和咽反射减弱、上跳性眼球震颤和步态共济失调。最初通过计算机断层扫描（CT）确诊为延髓出血。磁共振成像研究进一步显示，延髓旁正中血肿向背侧头端延伸至脑桥延髓交界处。它明确了髓内血肿的精确解剖边界，且与临床表现密切相关。该患者随后的预后良好，临床体征和症状逐渐改善。随访CT扫描显示血肿消退，预后与良好的神经功能恢复一致。
