Maeda Akiho, Hayashi Koji, Sato Mamiko, Suzuki Asuka, Nakaya Yuka, Maeda Hiroaki, Kobayashi Yasutaka
Department of Rehabilitation Medicine, Fukui General Hospital, Fukui, JPN.
Graduate School of Health Science, Fukui Health Science University, Fukui, JPN.
Cureus. 2025 Feb 6;17(2):e78612. doi: 10.7759/cureus.78612. eCollection 2025 Feb.
We describe a case of lateral medullary infarction (LMI) presenting with both body lateropulsion (BL) and urinary retention (UR). A 29-year-old Filipino male with a history of untreated hypertension, dyslipidemia, hyperuricemia, and obesity presented with acute onset of rotatory vertigo, gait disturbance, and left-sided sensory loss. Initial examination revealed horizontal nystagmus to the left, right-sided facial sensory loss, and left-sided limb sensory loss, without cranial nerve deficits or UR. Brain magnetic resonance imaging showed hyperintensities in the right dorsolateral medulla oblongata, leading to a diagnosis of LMI. Antiplatelet therapy and rehabilitation were initiated. Subsequently, the patient developed dysphagia, UR requiring intermittent catheterization, and right-sided Horner's syndrome. He also reported right-sided BL during gait training. Following medical and rehabilitative management, symptoms gradually improved, with the resolution of vertigo and UR by day 20, improved BL by day 40, and independent ambulation by day 70, despite persistent slight sensory disturbance. In this case report, we discuss the causes of BL and UR in LMI, comparing them with previous cases.
我们描述了一例表现为身体侧倾（BL）和尿潴留（UR）的延髓外侧梗死（LMI）病例。一名29岁的菲律宾男性，有未经治疗的高血压、血脂异常、高尿酸血症和肥胖病史，出现急性旋转性眩晕、步态障碍和左侧感觉丧失。初始检查发现向左的水平眼震、右侧面部感觉丧失和左侧肢体感觉丧失，无颅神经缺损或尿潴留。脑部磁共振成像显示右侧延髓背外侧高信号，导致LMI诊断。开始抗血小板治疗和康复治疗。随后，患者出现吞咽困难、需要间歇性导尿的尿潴留和右侧霍纳综合征。他还报告在步态训练期间出现右侧身体侧倾。经过药物和康复治疗，症状逐渐改善，第20天时眩晕和尿潴留消失，第40天时身体侧倾改善，第70天时可独立行走，尽管仍有持续轻微的感觉障碍。在本病例报告中，我们讨论了LMI中身体侧倾和尿潴留的原因，并与既往病例进行比较。
