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Published on: September 25, 2019
Progression rates of medulla oblongata infarcts in clinical follow-up: A retrospective study
Fergane Memmedova1, Semra Arı Sevingil1, Ulviyyat Jafarova1
1Eskisehir Osmangazi University, Department of Neurology, Eskisehir, Turkey.
Objective:
To determine clinical progression rates in patients with medulla oblongata infarction (MOI).
Materials And Methods:
The data of patients diagnosed with MOI were analysed retrospectively. Dermographic characteristics of the patients; Age, gender, history and stroke etiology were evaluated. Radiological imagings were reviewed retrospectively. Intensive care unit (ICU) requirement, number of intubation days, failed extubation and death rates, good clinical outcome at discharge and 3 months [modified Rankin Scale (mRS 0-2)] and poor clinical outcome (mRS 3-6) rates were evaluated. In addition, the clinical results of patients with medial medullary infarction (MMI) and lateral medullary infarction (LMI) were compared.
Results:
33 patients were included in the study, 22 (66.7 %) were male. The mean age of the patients was 72.0 (43.0-85.0). The characteristics of the patients (dermographic features, comorbidities, clinical symptoms, infarct localization, etc.) were evaluated. The results of MMI and LMI patients were compared. The intubation rate was 4 (44.4 %) in the MME group, while it was 8 (33.3 %) in the LME group. There was no statistically significant difference between the two groups in terms of failed extubation, tracheostomy, hospitalization and mortality rates. However, while discharge mRS was statistically significant between the two groups, the mRS at 3 months was not statistically significant. Twelve (36.4 %) of all patients were intubated due to severe clinical progression. In the clinical follow-up, 6 (50.0 %) of the intubated patients died, 3rd month mRS of 6 (50.0 %) patients who survived was 5. In all patients 3-month good clinical outcome rate was % 48,5.
Conclusion:
It should not be forgotten that life-threatening clinical progressions may develop at a considerable rate during the early treatment process of patients diagnosed with MOI.
Insights
Medulla oblongata infarction (MOI) patients face significant clinical progression, with nearly half experiencing poor outcomes. Early recognition and management are crucial due to potentially life-threatening complications.
Area of Science:
- Neurology
- Stroke Medicine
- Clinical Neurosciences
Background:
- Medulla oblongata infarction (MOI) is a critical neurological event.
- Understanding clinical progression and outcomes in MOI patients is essential for effective management.
Purpose of the Study:
- To determine clinical progression rates in patients diagnosed with medulla oblongata infarction (MOI).
- To compare clinical outcomes between medial medullary infarction (MMI) and lateral medullary infarction (LMI).
Main Methods:
- Retrospective analysis of 33 MOI patients.
- Evaluation of demographic characteristics, stroke etiology, and radiological findings.
- Assessment of intensive care unit (ICU) requirements, intubation, extubation, mortality, and modified Rankin Scale (mRS) scores at discharge and 3 months.
Main Results:
- 36.4% of patients required intubation due to severe clinical progression.
- Among intubated patients, 50% died, and survivors had a 3-month mRS of 5.
- The overall 3-month good clinical outcome rate (mRS 0-2) was 48.5%.
Conclusions:
- Medulla oblongata infarction can lead to life-threatening clinical progressions.
- A considerable rate of severe clinical progression necessitates vigilant monitoring and early intervention in MOI patients.
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