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延髓橄榄区梗死

[Infarction of the olivary area of the medulla oblongata].

作者信息

de Smet Y, Brucher J M, Gonsette R E

出版信息

Rev Neurol (Paris). 1984;140(10):559-66.

PMID:6505482
Abstract

The two first cases of an infarct involving the arterial olivary territory of the medulla oblongata are reported. In the first one, an old infarct of the medial territory and a recent infarct involving the whole inferior olivary nucleus at its middle third level were associated. Rostrally this infarct was reduced to the medial reticular formation and internal half of the olive. Caudally it was reduced to its external half. In the second case the infarct involved only the external half of the right olive, but involved also the external half of the left olive with the lateral territory. From these two cases and from the anatomic, pathologic and clinical data reviewed in the literature, the authors propose as "total" olivary territory a triangular area including all the inferior olivary nucleus, the dorsal accessory olivary nucleus and partly the medial reticular formation, and as "minimum" olivary territory the external half of the olive. The many important medial, lateral and cranio-caudal arteries which supply the olivary territory account for these "total" and "minimum" territories, as well as for some cases in the literature. They account also for the pyramid-like cranio-caudal extension of the olivary territory infarction. The olivary territory is likely to be supplied by two short circumferential arterial groups, i.e. inferior bulbar and superior medullo-pontine. Nevertheless, the cause of the olivary territory infarction is an occlusion of the vertebral artery.

摘要

报告了两例梗死累及延髓动脉橄榄区的病例。第一例,内侧区陈旧性梗死与近期梗死相关,近期梗死累及整个下橄榄核中间三分之一水平。在头侧,该梗死缩小至内侧网状结构和橄榄的内侧半。在尾侧,它缩小至外侧半。第二例梗死仅累及右侧橄榄的外侧半,但也累及左侧橄榄的外侧半及外侧区。根据这两例病例以及文献中回顾的解剖、病理和临床资料,作者提出将一个包括所有下橄榄核、背侧副橄榄核及部分内侧网状结构的三角形区域定义为“全部”橄榄区,将橄榄的外侧半定义为“最小”橄榄区。供应橄榄区的众多重要的内侧、外侧及头-尾侧动脉解释了这些“全部”和“最小”区域,以及文献中的一些病例。它们还解释了橄榄区梗死呈金字塔状的头-尾侧延伸。橄榄区可能由两组短的环行动脉供血,即延髓球下部和脑桥延髓上部动脉。然而,橄榄区梗死的病因是椎动脉闭塞。

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