Medial Medullary Infarction:Progression?Severity?and Outcome Study

Objective:To summarize the factors related to the progression,severity and prognosis of patients with medial medullary infarction.Methods:Retrospective analysis of our hospital from April 2012 to June 2016 in patients with acute medial medullary infarction.The risk factors,pathogenesis,clinical manifestations,radiological features and prognosis of the patients were analyzed.Results:In 34 cases,(1)85.3% patients with hypertension,79.4% were male,52.9% diabetes,the imaging examination of old lacunar infarction in 70.6% cases,50% cases of smoking;26.5% cases the onset after getting up,14.7% cases in tired,14.7% cases in activity,and 3%cases after drinking;29.4% cases of disease progression;(2)88.2% cases of motor dysfunction,82.4% cases dysarthria,55.9% cases of facial paralysis,52.9% tongue paralysis,44.1% limb sensory disturbance;(3)the infarct is located on the left side in 47.6%,44.1%in rostral,ventrl 38.2%,32.4% among ventro-dorsal;vertebral artery atherosclerosis61.8%;(4)the main pathogenesis for atherosclerosis,61.8% good prognosis in leave hospital.The progressive group compared with the non progressive stroke group,between the two groups in the incidence after getting up,atherosclerosis,lesions more than 2 level,small vessel disease,lesions involving the head + middle,the differences were statistically significant(P<0.05).Small group compared with moderate-severe stroke group,the stroke history,moderate-severe group motor dysfunction,facial paresis,dysphagia,hypoglossal palsy,the differences were statistically significant(P<0.05).A good prognosis compared with poor prognosis group,the stroke history,severe motor dysfunction,dysarthria,dysphagia,facial paresis,pharyngeal reflex disorder,hypoglossal palsy,lesions at thejunction+head,the difference was statistically significant(P<0.05).Conclusions:MMI was mostly in male.Hypertension,diabetes,smoking are the top 3 risk factors of MMI.The common clinical manifestation is motor dysfunction and dysarthria.The lesions of MMI were mostly located at the ventral,middle and upper part of medulla oblongata.