Department of Neurosurgery and Stroke Center, NTT Medical Center Tokyo, Japan.
Department of Neurosurgery and Stroke Center, NTT Medical Center Tokyo, Japan.
J Stroke Cerebrovasc Dis. 2014 Jan;23(1):191-3. doi: 10.1016/j.jstrokecerebrovasdis.2012.11.009. Epub 2012 Dec 6.
The patient, a 32-year-old man, presented with sudden onset of occipital headache, vertigo, dysarthria, gait ataxia, right Horner syndrome, numbness of the right hand, and mild right hemiparesis. On magnetic resonance imaging, an acute small infarction was located on the right side of the caudal medulla extending dorsomedially. Magnetic resonance angiography showed severe right vertebral artery stenosis. Lateral medullary infarction associated with ipsilateral sensorimotor deficits in the limb is very rare, and the lesion probably involved the ipsilateral dorsal column or decussating lemniscal fibers and corticospinal fibers caudal to the pyramidal decussation or compression of the decussation.
患者，一名 32 岁男性，突发枕部头痛、眩晕、构音障碍、步态共济失调、右侧霍纳氏综合征、右手麻木和轻度右侧偏瘫。磁共振成像显示急性小梗死位于延髓尾部右侧，向背内侧延伸。磁共振血管造影显示右侧椎动脉严重狭窄。伴有同侧肢体感觉运动功能障碍的延髓外侧梗死非常罕见，病变可能累及同侧背柱或交叉的薄束纤维和皮质脊髓纤维在锥体交叉下方或交叉受压。
