[Clinical and image diagnostics of brain stem infarction]

Clinical features and image diagnostic characteristics of brain stem infarction were studied in 28 patients to facilitate early diagnosis. Crossed hemiparesis was found in all the patients with medulla oblongata and midbrain infarction. Pontine infarction had a variety of clinical syndromes as follows: (1) crossed-hemiparesis in 8 cases (44.4%) and ipsilateral hemiataxia in one case. (2) tetraplegia in 3 cases (16.7%). (3) pure hemiparesthesia in 4 cases. (4) hemiparesis and hemiparesthesia without cranial nerve palsy in 3 cases (16.7%). MRI was found to be a very useful diagnostic measure for brain stem infarction with a positive rate of 82.6%. However, brain stem infarction was sometimes not revealed by MRI. Brain stem infarction could not be diagnosed by CT, but brainstem hemorrhage might be excluded by CT.