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资源有限医院中的延髓外侧综合征:缺血性卒中一种罕见的临床解剖变异

Lateral medullary syndrome in a resources limited hospital: A rare clinical anatomical variation of ischemic stroke.

作者信息

Ebraheem Ahmed Alsiddig, Dafallah Mumen Abdalazim, Mohamamed Khawla Abdelmonem Yousef

机构信息

Internal Medicine Department, Faculty of Medicine University of Gezira Wad Medani Gezira State Sudan.

Internal Medicine Department Sudan Medical Specialization Board Wad Medani Gezira State Sudan.

出版信息

Clin Case Rep. 2024 May 26;12(6):e8976. doi: 10.1002/ccr3.8976. eCollection 2024 Jun.

Abstract

KEY CLINICAL MESSAGE

Although it is rare, physicians should be familiar with the presentation of lateral medullary syndrome (LMS). Urgent neuroimaging is crucial to distinguish LMS from other causes of stroke. The majority experience significant improvement within months.

ABSTRACT

Lateral medullary syndrome is a rare type of stroke resulting from a vascular event in the lateral part of the medulla oblongata. Loss of pain and temperature in the ipsilateral side of the face, and contralateral side of the body along with ipsilateral ataxia, vertigo, nystagmus, dysphagia, and hiccups are the hallmark clinical presentation. We reported a case of a 51-year-old male with a long history of smoking and newly discovered hypertension who presented complaining of vomiting, regurgitation, and hiccups for 1 month; tingling and numbness sensation in the left side of the face and the right side of the body, and unsteady gait for 2 weeks. Neurological examinations revealed left-sided ptosis and miosis, diminished sensation of the three divisions of the trigeminal nerve, deviated uvula to the right side, absent gag reflex, and intention tremors. The patient received the appropriate treatment; showed a good recovery with his symptoms, was able to walk unsteady, and was discharged after 10 days in a good condition.

摘要

关键临床信息

尽管罕见,但医生应熟悉延髓外侧综合征(LMS)的表现。紧急神经影像学检查对于区分LMS与其他中风病因至关重要。大多数患者在数月内会有显著改善。

摘要

延髓外侧综合征是一种罕见的中风类型,由延髓外侧的血管事件引起。面部同侧和身体对侧的痛觉和温度觉丧失,以及同侧共济失调、眩晕、眼球震颤、吞咽困难和呃逆是其标志性临床表现。我们报告了一例51岁男性病例,该患者有长期吸烟史且新发现高血压,主诉呕吐、反流和呃逆1个月;左侧面部和右侧身体有刺痛和麻木感,步态不稳2周。神经系统检查发现左侧上睑下垂和瞳孔缩小、三叉神经三个分支感觉减退、悬雍垂偏向右侧、咽反射消失和意向性震颤。患者接受了适当治疗;症状恢复良好,能够行走但仍步态不稳,10天后状况良好出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfbb/11128493/7344dc406e6e/CCR3-12-e8976-g001.jpg

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