本研究旨在表征风险因素,病因学,临床表现,解剖学特征,中风机制,成像特征,双侧延髓内侧梗死(BMMI)的预后。回顾性分析2013年1月至2023年1月徐州医科大学附属医院11例符合纳入标准的BMMI患者的临床资料。对患者的影像学及临床特点进行分析和总结。11名患者(7名男性,4女),46至62岁,符合纳入标准。常见的临床表现包括构音障碍(90.9%),吞咽困难(90.9%),四肢瘫痪(81.8%),等等。发病72小时内,8例表现为四肢瘫痪,偏瘫2例,无肢体瘫痪1例。BMMI的主要危险因素是高血压,其次是糖尿病。“心脏外观”梗死4例(36.4%),“Y外观”梗死7例(63.6%)。在患者中,3例单侧椎动脉狭窄或闭塞,5例有双侧椎动脉狭窄或闭塞,2有正常的椎基底动脉,1例没有做脑血管检查。所有患者均接受脑梗死规范化治疗。预后很差,81.8%的患者有不利的结果,包括1人死亡,9例残疾,只有1名患者在康复后达到自我护理能力。BMMI在45至60岁的男性中更为普遍。主要危险因素是高血压和糖尿病。动脉粥样硬化是主要的病因亚型。主要临床表现为运动障碍,头晕,四肢瘫痪,和构音障碍.BMMI的预后较差。“心脏外观”或“Y外观”梗死的特定影像学特征有助于BMMI的诊断。
This study aimed to characterize the risk factors, etiology, clinical manifestations, anatomical characteristics, stroke mechanisms, imaging features, and prognosis of bilateral medial medullary infarction (BMMI). A retrospective analysis was conducted on 11 patients with BMMI who met the inclusion criteria at the Affiliated Hospital of Xuzhou Medical University from January 2013 to January 2023. The patients\' imaging and clinical features were analyzed and summarized. Eleven patients (7 male, 4 female), aged 46 to 62 years, met the inclusion criteria. Common clinical presentations included dysarthria (90.9%), dysphagia (90.9%), quadriplegia (81.8%), and so on. Within 72 hours of onset, 8 cases presented with quadriplegia, 2 cases with hemiplegia, and 1 case without limb paralysis. The main risk factor for BMMI was hypertension, followed by diabetes. \"Heart appearance\" infarcts occurred in 4 cases (36.4%), while \"Y appearance\" infarcts occurred in 7 cases (63.6%). Among the patients, 3 had unilateral vertebral artery stenosis or occlusion, 5 had bilateral vertebral artery stenosis or occlusion, 2 had normal vertebral basilar artery, and 1 did not undergo cerebrovascular examination. All patients received standardized treatment for cerebral infarction. The prognosis was poor, with 81.8% of patients having an unfavorable outcome, including 1 death, 9 cases of disability, and only 1 patient achieving self-care ability after recovery. BMMI is more prevalent in males aged 45 to 60 years. The main risk factors are hypertension and diabetes. Atherosclerosis is the primary etiological subtype. The main clinical manifestations are dyskinesia, dizziness, quadriplegia, and dysarthria. The prognosis of BMMI is poor. The specific imaging features of \"heart appearance\" or \"Y appearance\" infarcts aid in the diagnosis of BMMI.