CAJ | 학술논문

目的探讨双侧延髓内侧梗死的临床表现、病因、MRI特点及预后.方法总结2例双侧延髓内侧梗死患者的临床资料并复习相关文献.结果 2例患者在临床上表现为进展性四肢瘫痪,均累及呼吸；病因均为动脉粥样硬化所致,同时1例合并先天血管变异；影像学上,MRI弥散加权成像(DWI)显示延髓水平“Y”字型的高信号影；预后差,1例死亡,1例气管切开并遗留严重后遗症.结论双侧延髓内侧梗死症状复杂多样,以四肢瘫痪为主要特点,可合并舌下瘫、构音障碍,严重者引起呼吸衰竭,DWI可表现为特征性“Y”字型改变,预后不佳.
목적 탐토쌍측연수내측경사적림상표현、병인、MRI특점급예후.방법 총결2례쌍측연수내측경사환자적림상자료병복습상관문헌.결과 2례환자재림상상표현위진전성사지탄탄,균루급호흡；병인균위동맥죽양경화소치,동시1례합병선천혈관변이；영상학상,MRI미산가권성상(DWI)현시연수수평“Y”자형적고신호영；예후차,1례사망,1례기관절개병유류엄중후유증.결론 쌍측연수내측경사증상복잡다양,이사지탄탄위주요특점,가합병설하탄、구음장애,엄중자인기호흡쇠갈,DWI가표현위특정성“Y”자형개변,예후불가.
Objective To study the clinical manifestations,etiology,magnetic resonance imaging features,prognosis of patients with bilateral medial medullary infarction.Methods The clinical information of two case reports were summarized with review of the literature.Results The 2 patients with bilateral medial medullary infarction reported here were manifested with progressive quadriplegia,both complicated with respiratory disorders.On etiology,both were due to atherosclerosis,and one was combined with congenital vascular variation.The "Y shaped" hyperintense signals were seen in diffusion weighted imaging (DWI) cross-section in the medulla oblongata level.And both had poor outcomes that one was dead and the other was discharged with tracheotomy and severe sequela.Conclusions Bilateral medial medullary infarction is presented with complicated symptoms such as quadriplegia,dysarthria,hypoglossoplegia,even respiratory failure,in which quadriplegia is most often seen,and it is associated with a poor clinical prognosis.DWI appears the characteristic "Y Shaped" sign.