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The stroke mechanism, clinical presentation, and radiological feature of bilateral medial medullary infarction

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Abstract

Background

Bilateral medial medullary infarction (BMMI) is a rare type of posterior circulation stroke. The aim of this study is to characterize its stroke mechanisms, clinical manifestations, neuroradiological features, and prognosis.

Methods

From January 2015 to June 2021, a retrospective review of 15 patients diagnosed with BMMI was conducted. The clinical and neuroradiological features were summarized by our experienced neurologists.

Results

Fifteen patients (12 male, 3 female), ranging in age from 48 to 72 years, satisfied the inclusion criteria. The common clinical presentations included motor weakness (100%), deep sensory disturbance (93.3%), vertigo/dizziness (80%), dysarthria (93.3%), and dysphagia (66.7%). Vertically, infarct lesions in the rostral medulla were observed in all included patients. Horizontally, “heart appearance,” “Y appearance,” and “fan appearance” infarcts occurred in 9 cases (60%), 5 cases (33.3%), and 1 (6.7%) case, respectively. Patients (53.3%) had severe stenosis or occlusion in unilateral vertebral artery (VA), and 33.3% had normal findings in the vertebrobasilar artery. Patients (93.3%) achieved poor prognosis.

Conclusion

BMMI is more frequently located in the rostral medulla and comprises three forms of infarction. The two main stroke etiologies of BMMI are large-artery atherosclerosis (LAA) and small vessel disease (SVD). BMMI is always associated with bad clinical outcome.

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Authors and Affiliations

  1. Department of Neurology, Donghu District, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, No. 92 Aiguo Road, Nanchang, Jiangxi Province, 330006, China

    Fan Hu, Hongbing Nie, Lingjuan Li & Yaoyao Shen

  2. Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China

    Yuzhen Bai

  3. Department of Neurology, Nanyang Central Hospital, Nanyang, Henan Province, China

    Xinming Liang

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  1. Fan Hu
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  2. Hongbing Nie
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  3. Yuzhen Bai
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  4. Xinming Liang
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  5. Lingjuan Li
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Correspondence to Yaoyao Shen.

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Hu, F., Nie, H., Bai, Y. et al. The stroke mechanism, clinical presentation, and radiological feature of bilateral medial medullary infarction. Neurol Sci 43, 6881–6888 (2022). https://doi.org/10.1007/s10072-022-06382-4

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  • DOI: https://doi.org/10.1007/s10072-022-06382-4

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