Alawadhi Abdulla, Saint-Martin Christine, Sabapathy Christine, Sebire Guillaume, Shevell Michael
Division of Pediatric Neurology, Departments of Pediatrics & Neurology/Neurosurgery, The Montreal Children's Hospital, McGill University, Montreal, Québec, Canada.
Department of Medical Imaging, The Montreal Children's Hospital, McGill University, Montreal, Québec, Canada.
Child Neurol Open. 2019 Aug 6;6:2329048X19867800. doi: 10.1177/2329048X19867800. eCollection 2019.
Lateral medullary syndrome is rare in pediatrics. It is characterized by neurological deficits due to an ischemic lesion in the lateral medulla. The authors describe a 17-year-old boy who developed lateral medullary syndrome in the context of a hyperflexion neck injury while diving in shallow water with traumatic vascular injury. He had "crossed" neurological deficits above and below the neck. His magnetic resonance angiography showed intra- and extracranial left vertebral artery occlusion and his magnetic resonance imaging showed signal abnormality involving the left lateral medulla and inferomedial cerebellum in keeping with an infarct secondary to left vertebral artery and left posterior inferior cerebellar artery occlusion. Good neurological recovery was observed on heparin therapy started after surgical treatment of traumatic injury. To our knowledge, this is the first reported case of lateral medullary syndrome in a pediatric population related to a flexion neck injury. The authors emphasize the importance of a high level of suspicion for accurate diagnosis.
外侧延髓综合征在儿科中较为罕见。它的特征是由于外侧延髓的缺血性病变导致神经功能缺损。作者描述了一名17岁男孩，他在浅水中潜水时因颈部过度屈曲损伤伴外伤性血管损伤而患上外侧延髓综合征。他在颈部上下出现了“交叉性”神经功能缺损。他的磁共振血管造影显示颅内和颅外左侧椎动脉闭塞，磁共振成像显示左侧外侧延髓和小脑下内侧信号异常，符合左侧椎动脉和左侧小脑后下动脉闭塞继发的梗死。在对外伤进行手术治疗后开始肝素治疗，观察到神经功能恢复良好。据我们所知，这是首次报道的儿科人群中与颈部屈曲损伤相关的外侧延髓综合征病例。作者强调了高度怀疑对于准确诊断的重要性。
