Li Xuan-Ting, Yuan Jun-Liang, Hu Wen-Li
Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
World J Clin Cases. 2019 Jan 6;7(1):73-78. doi: 10.12998/wjcc.v7.i1.73.
Millard-Gubler syndrome (MGS) is caused by a lesion in the brainstem at the level of the facial nerve nucleus, and it is also a rare ventral pontine syndrome. Vertebrobasilar artery dissection (VAD) is an uncommon cause of ischemic stroke. To the best of our knowledge, this is the first case report on the coexistence of MGS and VAD in a young acute ischemic stroke patient.
We herein describe an unusual case of young acute ischemic stroke patient, presenting with acute right peripheral facial palsy, right abducens palsy, and contralateral hemihypesthesia, manifesting as MGS. After receiving dual antiplatelet therapy with aspirin and clopidogrel, as well as rosuvastatin, the patient recovered significantly. The high-resolution magnetic resonance imaging (MRI) indicated a diagnosis of VAD.
Our finding further demonstrated that high-resolution MRI is a useful technique to early detect underlying dissection in posterior circulation ischemic stroke.
米拉德 - 古布勒综合征(MGS)由面神经核水平的脑干病变引起,也是一种罕见的脑桥腹侧综合征。椎基底动脉夹层(VAD)是缺血性卒中的罕见病因。据我们所知,这是首例关于年轻急性缺血性卒中患者同时存在MGS和VAD的病例报告。
我们在此描述了一例年轻急性缺血性卒中患者的罕见病例,该患者表现为急性右侧周围性面瘫、右侧展神经麻痹和对侧半身感觉减退,符合MGS表现。在接受阿司匹林和氯吡格雷双重抗血小板治疗以及瑞舒伐他汀治疗后,患者恢复显著。高分辨率磁共振成像(MRI)显示诊断为VAD。
我们的发现进一步证明,高分辨率MRI是早期检测后循环缺血性卒中潜在夹层的有用技术。