Day Gregory S, Swartz Richard H, Chenkin Jordan, Shamji Adil I, Frost David W
CJEM. 2014 Mar;16(2):164-70. doi: 10.2310/8000.2013.131059.
Patients with lateral medullary syndrome classically present with crossed hemisensory disturbance, ipsilateral Horner syndrome, and cerebellar signs, all of which are attributable to infarction of the lateral medulla. However, variability in the presentation of this syndrome is the rule, as illustrated in this case presentation and literature review. We propose an approach to diagnosis and management of the lateral medullary syndrome and illustrate the need to integrate clinical information with an understanding of brainstem anatomy with the goal of determining which patients require urgent neuroimaging and acute stroke therapies. The importance of recognition of this condition in the emergency department is underscored by the association between lateral medullary infarction and vertebral artery dissection. With optimal therapy, the prognosis for recovery from lateral medullary syndrome is good.
延髓外侧综合征患者通常表现为交叉性半身感觉障碍、同侧霍纳综合征和小脑体征，所有这些都归因于延髓外侧梗死。然而，正如本病例报告和文献综述所示，该综合征表现的变异性是常态。我们提出一种延髓外侧综合征的诊断和管理方法，并说明将临床信息与对脑干解剖结构的理解相结合的必要性，目的是确定哪些患者需要紧急神经影像学检查和急性中风治疗。延髓外侧梗死与椎动脉夹层之间的关联凸显了在急诊科识别这种情况的重要性。通过最佳治疗，延髓外侧综合征的恢复预后良好。
