Kent Hospital Emergency Medicine Residency Program, Warwick, RI.
Kent Hospital Emergency Department Attending, Warwick, RI.
R I Med J (2013). 2023 Sep 1;106(8):16-17.
Posterior circulation cerebrovascular events comprise approximately 20% of ischemic events in the brain. Symptoms range from dizziness to profound ataxia altering gait. The majority of cases have some spectrum of dizziness. In this case report, we discuss a dorsolateral medullary stroke which atypically presented with dysphagia and without dizziness or ataxia. Although initial computed topography scans did not show large vessel occlusion or acute infarct, magnetic resonance imaging showed a right dorsolateral medullary infarct. Treatment is similar to other ischemic cerebrovascular accidents, including aspirin and high-intensity statin therapy, as well as thrombolysis if indicated. Pharyngeal dysfunction places a patient at higher risk for aspiration and pneumonia.
后循环脑血管事件约占大脑缺血性事件的 20%。症状范围从头晕到严重的共济失调改变步态。大多数病例都有某种程度的头晕。在本病例报告中，我们讨论了一例不典型表现为吞咽困难而无头晕或共济失调的延髓外侧部卒中。尽管初始计算机断层扫描未显示大血管闭塞或急性梗死，但磁共振成像显示右侧延髓外侧梗死。治疗与其他缺血性脑血管意外相似，包括阿司匹林和高强度他汀类药物治疗，如果有指征还包括溶栓治疗。咽部功能障碍使患者更容易发生吸入和肺炎。
