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•论著.双侧延髓内侧梗死临床分析温蒲圆刘宏毕喜壮邵华飞曲蕴慧褚文政【摘要】目的分析并探究双侧延髓内侧梗死(BMMI)的血管病因、临床表现、MR1特征和预后，以期提高BMMI的早期诊断率。
方法对青岛大学附属烟台毓璜顶医院诊治的14例BMMI患者临床资料进行分析：结果BMMI血管病因以动脉粥样硬化为主；临床症状表现为四肢瘫痪、舌瘫、感觉异常、头晕、构音障碍、饮水呛咳等，危重时出现呼吸衰竭°头颅DWI示双侧延髓内侧可呈特征性“心型”、“Y”字型、“V”字型或倒“八”字型高信号影。
出院NIHSS评分、卒中进展(尤其呼吸衰竭)为BMMI的预后不良因素。
结论BMMI临床少见，临床表现多样，预后较差；头颅MRI为其主要的影像学检查，有助于早期诊断：【关键词】脑梗死；双侧延髓内侧；临床表现；DWI；预后不良因素中图分类号：R743.32文献标识码：A文章标号：1006-351X(2021)03-0143-0Clinical analysis of14patients with bilateral medial medullary infarctionWen Puvuan,Liu Hong,Bi Xizhuang,Shao Huafei,Qu Yunhui,Chu WertzhengDepartment of N eurologic the Intensdive Care Un i t,the Yuhuangding of Yanta,Shandong264000,ChinaCorresponding author:Chu Wenzheng,Ernail:bzchu@[Abstract]Objective To improve the early diagnosis of BMMI by analyzing and discussing its vascularetiology,clinical manifestation,MRI features and prognosis.Methods Clinical data of14BMMI patients admitted byYuhuangding Hospital Affiliated to Qingdao University was analyzed retrospectively.Results Atherosclerosis was themain pathogenesis of BMMI;The clinical manifestations of BMMI were mainly quadriplegia,tongue paralysis,dizziness,dysarthria,drinking water cough,etc,respiratory failure in critical cases.Brain diffusing weighted imaging(DWI)showed typical"heart-"shape,"Y-"shape,"V-"shape and"reversed eight-"shape of hyperintensities.NIHSSscore at discharge and stroke progression(especially respiratory failure)were the possible poor predictors of BMMIprognosis.Conclusions BMMI is rare in clinic with diverse clinical manifestations and poor prognosis.Brain MRI isthe main imaging examination method,which is helpful for early diagnosis.[Key words]Cerebral infarction;Bilateral medial medulla oblongata;Clinical manifestation;DWI;Poorprognostic factor延髓侧支循环好，血供丰富，临床上延髓梗死较为少见，约占椎-基底动脉系统梗死的5%。
