Li Hui, Wei Na, Zhang Lu, Liu Xiuli, Han Jingzhe
Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei, China.
J Int Med Res. 2020 Nov;48(11):300060520970773. doi: 10.1177/0300060520970773.
Isolated body lateropulsion is a possible predominant manifestation of medulla oblongata infarction, and can occur without vestibular and cerebellar symptoms. However, it is relatively rare and challenging to diagnose.
A 67-year-old woman was admitted to the Harris International Peace Hospital complaining mainly of instability when standing and walking for the previous 8 hours. Based on the neural localization and multiple head magnetic resonance imaging (MRI) examinations, a diagnosis of cerebral infarction (vertebrobasilar system) was made. Consequently, the patient was managed using therapy aimed at preventing platelet aggregation, lowering plasma lipids, stabilizing plaques, protecting mitochondria, and improving circulation and brain function. The patient's gait improved and she was discharged after 14 days because she was able to walk unaided. The patient was followed up for 6 months and had no noticeable undesirable side effects or signs of neurological deficits.
The possibility of lateral medulla oblongata infarction should be considered when patients present with isolated body lateropulsion, without other signs or symptoms of brainstem damage.
孤立性身体侧推是延髓梗死可能的主要表现，可在无前庭和小脑症状的情况下发生。然而，其相对罕见且诊断具有挑战性。
一名67岁女性因在前8小时站立和行走时主要抱怨不稳定而入住哈里斯国际和平医院。基于神经定位和多次头部磁共振成像（MRI）检查，诊断为脑梗死（椎基底系统）。因此，对患者采用了旨在预防血小板聚集、降低血脂、稳定斑块、保护线粒体以及改善循环和脑功能的治疗方法。患者的步态得到改善，14天后能够独立行走，随后出院。对患者进行了6个月的随访，未发现明显的不良副作用或神经功能缺损迹象。
当患者出现孤立性身体侧推且无其他脑干损伤体征或症状时，应考虑延髓外侧梗死的可能性。
