| Objective: This study focused on the analysis of the correlation between vertebrobasilar artery lesions and different types of Wallenberg’s syndrome.methods: Patients with acute posterior circulation cerebral infarction admitted to the Second Department of Neurology of Central Hospital from October 2020 to October 2022 were consecutively collected.Within72 hours of hospitalization,new cerebral infarcts in the dorsolateral medulla were confirmed by diffusion weighted imaging(DWI),and the diagnosis of wallenberg syndrome was confirmed by combining the clinical symptoms of the patients.After screening,31 patients met the criteria and had complete medical records.Patients completed CTA Or DSA vascular assessment tests during their hospitalization.The subjects were divided into a vertebral artery lesion group and a nonvertebral artery lesion group in this study according to the patients’ lesioned vessels.All patients underwent magnetic resonance examination,and the medulla oblongata was divided longitudinally into 3 levels according to the Kim partitioning method: the posterior lateral convex plane of the cord,the nodular outer surface plane of the olivary nucleus,and the dense circular flat of the fourth ventricle forming an opposing dense circular plane.At the horizontal level,the lateral aspect of the medulla oblongata was divided into five regions A,B,C,D,and E.Among them,A+B+C is a large infarct,A+B is a typical infarct,and B+C is a ventral infarct.Patients in the vertebral artery lesion group and the non-vertebral artery lesion group were compared with each other on different infarct models of dorsolateral infarcts of the medulla oblongata to investigate the correlation between vertebral artery lesions and different types of Wallenberg’s syndrome.Results: In 18 patients with vertebral artery lesions versus 13 patients with non-vertebral artery lesions,the middle portion of the medulla oblongata was the most common site of infarction in Wallenberg syndrome in terms of the longitudinal distribution of infarct lesions,accounting for 70.96%.The two groups of patients with Wallenberg syndrome with different responsible vessels differed in infarcts in the middle part of the medulla(P=0.028),whereas there were no significant differences in infarcts in the upper and lower parts of the medulla(P=0.655,P=0.739).With regard to the horizontal distribution of infarct lesions,typical site(A+B)accounted for 87.09%,Typical site(A+B)accounted for 87.09%there was a difference in the proportion of different responsible vessels between the two groups in the typical infarct areas of medullary A and B infarcts(P=0.022,P=0.047),while there was no statistically significant difference between the two groups for medullary C,D and E infarcts(P=0.786,P=0.691,P=0.705).In terms of vertebral artery lesions,the most common vertebral artery lesions in Wallenberg syndrome were vertebral artery stenosis or occlusion in 13 cases(72.22%),vertebral artery dysplasia in 4 cases(22.22%),and vertebral artery entrapment in 1 case(5.55%).13 cases of vertebral artery stenosis or occlusion and 4 cases of vertebral artery dysplasia in patients with Wallenberg syndrome were found in the medulla A In the case of infarcts in parts A and B,there was a significant difference in the proportion of diseased vessels between the two groups(P < 0.05),whereas in the case of infarcts in parts C,D,and E of the medulla,there was no statistical difference between the two groups with different responsible vessels(P > 0.05).Conclusions: 1.In patients with Wallenberg syndrome vertebral artery lesion is more likely to form infarction of the typical site of the dorsolateral aspect of the medulla oblongata;2.In patients with Wallenberg syndrome vertebral artery lesion is more likely to cause infarction of the dorsal middle segment of the medulla oblongata;3.The most common vascular lesion factor for the development of Wallenberg syndrome in the middle-aged and elderly group of patients is vertebral artery lesion. |
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