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Published on: June 7, 2011
Clinical Study of 27 Patients with Medial Medullary Infarction
Takayoshi Akimoto1, Katsuhiko Ogawa1, Akihiko Morita1
1Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Background:
Medial medullary infarction (MMI) is a rare ischemic stroke. Frequency of each neurological finding in MMI was different in each study.
Methods:
We retrospectively evaluated the medical records of patients with cerebral infarction who were admitted between March 1998 and October 2015. Patients in our study were diagnosed as having MMI by magnetic resonance image examination.
Results:
Of 2727 patients with ischemic stroke, 27 patients (20 males and 7 females) had MMI. The MMI was complicated by infarcts located in the pons (n = 6), cerebellum (n = 2), and lateral medulla (n = 1). One patient had bilateral MMI. Large-artery atherosclerosis was the most common etiology. Motor weakness of the extremities was the most common neurological finding. Diminished contralateral superficial sensation was more common than diminished contralateral vibratory sensation, and these 2 types of sensory disturbance were often complicated. The patients with large MMI significantly more often accompanied diminished touch (P = .003), pain (P = .017), and vibratory (P = .019) sensation. Facial weakness was shown more common contralateral to the infarcts than ipsilateral (n = 8 contralateral, n = 1 ipsilateral). Lingual palsy was also more common contralateral to the lesions (n = 3 contralateral, n = 1 ipsilateral). One patient alone fulfilled the classical Dejerine triad.
Conclusions:
In MMI, motor weakness of extremities was commonly shown, and complication of diminished sensations indicated the large infarcts. As for facial weakness and lingual palsy, the supranuclear type was more prominent than the infranuclear type.
Insights
Medial medullary infarction (MMI) is a rare stroke. Motor weakness and sensory loss are common, with larger infarcts correlating to more severe sensory deficits. Facial and tongue weakness are typically supranuclear.
Area of Science:
- Neurology
- Neuroscience
- Internal Medicine
Background:
- Medial medullary infarction (MMI) is an uncommon type of ischemic stroke.
- Neurological findings in MMI vary across studies.
Purpose of the Study:
- To analyze the frequency and characteristics of neurological findings in patients with medial medullary infarction.
- To investigate the relationship between infarct size and neurological deficits in MMI.
Main Methods:
- Retrospective analysis of medical records of patients diagnosed with MMI via MRI.
- Evaluation of neurological findings, infarct locations, and etiologies in a cohort of MMI patients.
Main Results:
- Out of 2727 ischemic stroke patients, 27 had MMI, with large-artery atherosclerosis being the most common cause.
- Motor weakness of extremities was the most frequent neurological finding.
- Diminished superficial and vibratory sensations were common, especially in larger MMI cases. Supranuclear facial weakness and lingual palsy were more prevalent than infranuclear types.
Conclusions:
- Motor weakness and sensory disturbances are key features of MMI, with larger infarcts leading to more pronounced sensory loss.
- Supranuclear facial weakness and lingual palsy are more characteristic of MMI than infranuclear types.
