Department of Neurology, Donghu District, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, No. 92 Aiguo Road, Nanchang, Jiangxi Province, 330006, China.
Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
Neurol Sci. 2022 Dec;43(12):6881-6888. doi: 10.1007/s10072-022-06382-4. Epub 2022 Sep 9.
Bilateral medial medullary infarction (BMMI) is a rare type of posterior circulation stroke. The aim of this study is to characterize its stroke mechanisms, clinical manifestations, neuroradiological features, and prognosis.
From January 2015 to June 2021, a retrospective review of 15 patients diagnosed with BMMI was conducted. The clinical and neuroradiological features were summarized by our experienced neurologists.
Fifteen patients (12 male, 3 female), ranging in age from 48 to 72 years, satisfied the inclusion criteria. The common clinical presentations included motor weakness (100%), deep sensory disturbance (93.3%), vertigo/dizziness (80%), dysarthria (93.3%), and dysphagia (66.7%). Vertically, infarct lesions in the rostral medulla were observed in all included patients. Horizontally, "heart appearance," "Y appearance," and "fan appearance" infarcts occurred in 9 cases (60%), 5 cases (33.3%), and 1 (6.7%) case, respectively. Patients (53.3%) had severe stenosis or occlusion in unilateral vertebral artery (VA), and 33.3% had normal findings in the vertebrobasilar artery. Patients (93.3%) achieved poor prognosis.
BMMI is more frequently located in the rostral medulla and comprises three forms of infarction. The two main stroke etiologies of BMMI are large-artery atherosclerosis (LAA) and small vessel disease (SVD). BMMI is always associated with bad clinical outcome.
双侧延髓内侧梗死（Bilateral Medial Medullary Infarction，BMMI）是一种罕见的后循环卒中类型。本研究旨在描述其发病机制、临床表现、神经影像学特征和预后。
回顾性分析 2015 年 1 月至 2021 年 6 月期间 15 例确诊为 BMMI 的患者，由经验丰富的神经科医生总结其临床和神经影像学特征。
15 例患者（男 12 例，女 3 例），年龄 48~72 岁，符合纳入标准。常见临床表现包括运动无力（100%）、深感觉障碍（93.3%）、眩晕/头晕（80%）、构音障碍（93.3%）和吞咽困难（66.7%）。所有患者延髓上段均存在梗死病灶。水平位上，9 例（60%）呈“心形”、5 例（33.3%）呈“Y 形”、1 例（6.7%）呈“扇形”梗死。53.3%的患者单侧椎动脉严重狭窄或闭塞，33.3%的患者椎基底动脉正常。93.3%的患者预后不良。
BMMI 更多位于延髓上段，梗死类型包括三种。BMMI 的两个主要发病机制是大动脉粥样硬化（LAA）和小血管疾病（SVD）。BMMI 常与不良临床预后相关。
