Stroke, Vol 25, 1405-1410, Copyright © 1994 by American Heart Association
JS Kim, JH Lee, DC Suh and MC Lee
BACKGROUND AND PURPOSE: Computed tomography is insufficient in evaluation
of medullary lesions. Although lateral medullary infarction is a relatively
common type of cerebrovascular disease, detailed correlation between
clinical findings and magnetic resonance imaging (MRI) has not yet been
reported. METHODS: We studied 33 consecutive patients with lateral
medullary infarction who showed appropriate MRI lesions and correlated
their clinical findings with the MRI results. RESULTS: Gait ataxia (88%),
vertigo/dizziness (91%), nausea/vomiting (73%), dysphagia (61%), hoarseness
(55%), Horner sign (73%), and facial (85%) and hemibody (94%) sensory
changes were frequent clinical findings. MRI results showed that the
lesions located in the rostral part of the medulla were usually diagonal
band-shaped and were associated with more severe dysphagia, hoarseness, and
the presence of facial paresis, whereas the caudal lesions, situated
usually in the lateral surface of the medulla, appeared to correlate with
more marked vertigo, nystagmus, and gait ataxia. Nausea/vomiting and Horner
sign were common regardless of the lesion location, and lesions extending
ventromedially correlated with facial sensory change on the contralateral
side of the lesion. CONCLUSIONS: Analysis of MRI findings in rostrocaudal
and dorsoventral aspects allows us, although not unequivocally, to make
anatomicoclinical correlations in the evaluation of patients with lateral
medullary stroke syndrome.
ARTICLES
Spectrum of lateral medullary syndrome. Correlation between clinical findings and magnetic resonance imaging in 33 subjects
Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, South Korea.
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