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Clinical Review of 37 Patients with Medullary Infarction.
MedLine Citation:
PMID:  21376629     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Clinical features of medullary infarction were compared between patients with lateral medullary infarction and medial medullary infarction METHODS: Thirty-seven patients with medullary infarction (29 with lateral medullary infarction and 8 with medial medullary infarction) who were admitted to our center between April 1, 2007 and March 31, 2010 were examined. Background factors, neurologic signs and symptoms, imaging findings, cause of disease, and outcomes were assessed for patients with lateral and those with medial medullary infarction. RESULTS: Examination of the clinical symptoms and neurologic findings suggested that among patients with medial medullary infarction, few demonstrated all of the symptoms of Dejerine syndrome at onset, and many had lesions that were difficult to locate based only on neurologic findings. Both lateral and medial medullary infarction were frequently caused by atherothrombosis. However, cerebral artery dissection was observed in 31% of patients with lateral medullary infarction and 12.5% of those with medial medullary infarction. In 13% of patients with lateral and 37% of patients with medial medullary infarction, magnetic resonance imaging diffusion-weighted images on the day of onset did not show abnormalities, and the second set of diffusion-weighted images confirmed infarction lesions. For lateral medullary infarction, a more rostral lesion location was correlated with a poorer 90-day outcome. For medial medullary infarction, a more dorsal lesion location was correlated with a poorer 90-day outcome. CONCLUSIONS: The diagnosis rate of medullary infarction using imaging examinations at onset-particularly medial medullary infarction-is not necessarily high. The imaging examinations need to be repeated for patients who are suspected to have medullary infarction based on neurologic signs and symptoms.
Authors:
Takuya Fukuoka; Hidetaka Takeda; Tomohisa Dembo; Harumitu Nagoya; Yuji Kato; Ichiro Deguchi; Hajime Maruyama; Yohsuke Horiuchi; Akira Uchino; Susumu Yamazaki; Norio Tanahashi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-3
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  -     ISSN:  1532-8511     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Saitama, Japan.
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