相同还是相反？中风中头部运动无力与肢体轻瘫的关联。
Same or opposite? Association of head-movement weakness with limb paresis in stroke.
作者信息
Anagnostou Evangelos, Paraskevas Georgios P, Spengos Konstantinos, Vassilopoulou Sophia, Zis Vasileios, Vassilopoulos Dimitrios
机构信息
Department of Neurology, Eginition Hospital, University of Athens, Vas. Sophias Avenue 74, Athens, Greece.
出版信息
Neurologist. 2011 Nov;17(6):309-11. doi: 10.1097/NRL.0b013e318224ed5a.
OBJECTIVES
The precise innervation of the sternocleidomastoids is uncertain. Of clinical interest is whether a unilateral hemispheric lesion leads to an ispilateral or contralateral sternocleidomastoid weakness.
METHODS
Sternocleidomastoid strength was assessed in 124 consecutive acute stroke patients during yaw, pitch, and roll head movements. This was correlated with limb paresis and neuroimaging findings.
RESULTS
The incidence and the degree of sternocleidomastoid paresis were low (16.9%). In all cases, head rotation weakness away from the affected hemisphere was observed. Lateral tilt and vertical head rotations were unaffected. No weakness was detected in lesions that did not cause manifest limb paresis.
CONCLUSIONS
Our data point to an ipsihemispheric sternocleidomastoid control. Sternocleidomastoid paresis in stroke is expected only with concomitant limb paresis and is always less severe. Head tilt is not affected probably due to sparing of ancillary neck-muscle function.
目的
胸锁乳突肌的精确神经支配尚不确定。具有临床意义的是，单侧半球病变是否会导致同侧或对侧胸锁乳突肌无力。
方法
对124例连续的急性中风患者在头部偏航、俯仰和滚动运动时的胸锁乳突肌力量进行评估。将其与肢体轻瘫和神经影像学结果相关联。
结果
胸锁乳突肌轻瘫的发生率和程度较低（16.9%）。在所有病例中，均观察到远离患侧半球的头部旋转无力。侧向倾斜和垂直头部旋转未受影响。在未引起明显肢体轻瘫的病变中未检测到无力。
结论
我们的数据表明胸锁乳突肌受同侧半球控制。中风时胸锁乳突肌轻瘫仅在伴有肢体轻瘫时出现，且总是较轻。头部倾斜可能未受影响，这可能是由于辅助颈部肌肉功能未受影响。
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