The Clinical And Influence Factors Of Medullary Infarction

ObjectiveTo summarize the clinical of medulla infarction(MI),research the affect factors of cross-sectional distribution,explore the influence factors of severity,progression and prognosis with medullary infarction.Methods:We retrospectively analyzed the patiens diagnosed as acute MI who were treated from May 2012 to June 2017 in Deparment of Neurology,the First Hospital of Shanxi Medical University.Conclusion the disease' characteristics of lateral medullary infarction(LMI)and medial medullary infarction(MMI),such as risk factors,clinical and radiological features,pathogenesis,disease severity,progress,and prognosis.Find the correlation between each pair of symptoms and research the affect factors of cross-sectional distribution,further explore the influence factors of severity,progression and prognosis with medullary infarction.Results:A total of 126 cases of MI were registered.They included 89 cases of LMI and 37 cases of MMI,,male-to-female ratio were 3.2:1 and 3.1:1,the mean onset age was(54.9±12.7)and(59.9±11.8),respectively.The most common risk factor and pathogenesis of MI was hypertension and large artery atherosclerosis(LAA).In LMI,the frequently location was in the middle,lower and middle+lower medulla,the common symptoms were sensory dysfunction(90.6%),dizziness/vertigo(81.1%),ataxia(62.3%),pharyngeal reflex disorder(60.4%),Horner's sign(58.5%),nausea/vomiting(52.8%),dysarthria(47.2%),facial palsy(41.5%).In MMI,the frequently location was in the upper and upper+middle medulla,the common symptoms were motor weakness(92.6%),dizziness/vertigo(63.0%),dysarthria(66.7%),sensory dysfunction(55.6%),facial palsy(51.9%),hypoglossal palsy(44.4%).Symptoms such as dizziness/vertigo,nausea/vomiting,nystagmus,hiccups usually tended to co-occur,whereas pharyngeal reflex disorder,dysphagia,hoarseness,Horner sign tended to occur simultaneously in one patient.Headache found no contact with other symptoms.In MI,age was the influence factor to the cross-sectional distribution,the older prone to MMI.In the case of other factors unchanged,when age increased a level,the probability of happening MMI increased 1.968 times.The illness degree of those patiernts whose gender was male,lesion located in medial medullary and alonged with complications were relatively heavier.MMI groups were more likely to progress.For the moderate-severe stroke,the probability of male were 4.419 times of the female,the probability of MMI patients were 3.291 times of LMI patients,the probability of patients who had complications were 2.597 times of patients who had not.MMI were more likely to progress,the probability of MMI progress was 4.244 times of LMI.The patients whose lesion located in medial medullary,alonged with hypertension,the stroke degree was moderate-severe were relatively had a poor prognosis.For the poor prognosis probability,MMI was 12.885 times of LMI,patients who had hypertension were 6.731 times of those who hadn't,moderate-severe stroke group was 8.274 times of small group.Conclusions:In MI,the incidence of male was three times of female,the most common risk factor was hypertension,LAA was the predominant pathology.LMI had higher incidence than MMI,the mean onset age of MMI patients was approximately 5 years older than that of LMI patients.The lesion of LMI is frequently located in the middle medulla,the most common symptoms were sensory dysfunction.In MMI,the frequently location was upper medulla,the most common symptoms were motor weakness.In MI,age was influence factors to the cross-sectional distribution.The degree of the illness of those patiernts whose gender was male,lesion located in medial medullary and alonged with complications were relatively heavier.MMI groups were more likely to progress.The patients whose lesion located in medial medullary,alonged with hypertension,the stroke degree was moderate-severe were relatively had a poor prognosis.