Wada Yuko, Takahashi Ryuichi, Yanagihara Chie, Nishimura Yo
Department of Neurology, Nishi-Kobe Medical Center, 5-7-1 Koujidai, Nishi-ku, Kobe, Hyogo 651-2273, Japan.
Brain Nerve. 2009 Jan;61(1):72-6.
Lateropulsion of the body is rarely encountered as an isolated or predominant manifestation of pontine cerebrovascular disease. We compared 2 cases of pontine vascular lesions with 3 cases of lateral medullary infarction; all the patients had presented with body lateropulsion. The patients with pontine lesions tended to full on the side contralateral to the lesion,whereas the patients with lateral medullary infarction, fell on the ipsilateral side. Lateropulsion itself improved within 1 or 2 weeks in all the patients. The pontine lesion was localized to the paramedian tegmentum, just ventral to the fourth ventricle, while the medullary infarction was localized to the lateral surface of the medulla oblongata. The present findings support the possibility that body lateropulsion in patients with pontine vascular lesion is attributed to lesions in the graviceptive pathway that ascends through the paramedian pontine tegmentum.
身体向患侧偏斜很少作为脑桥脑血管疾病的孤立或主要表现出现。我们将2例脑桥血管病变患者与3例延髓外侧梗死患者进行了比较;所有患者均有身体向患侧偏斜的表现。脑桥病变患者倾向于向病变对侧跌倒,而延髓外侧梗死患者则向同侧跌倒。所有患者的身体向患侧偏斜在1或2周内均有改善。脑桥病变位于第四脑室腹侧的脑桥旁正中被盖,而延髓梗死位于延髓外侧表面。目前的研究结果支持这样一种可能性,即脑桥血管病变患者的身体向患侧偏斜归因于通过脑桥旁正中被盖上升的重力感受通路的病变。