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Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Medial medullary infarction: clinical, radiological findings and long-term prognosis
Mine Sezgin1, Gulshan Aliyeva2, Esme Ekizoğlu2
1Department of Neurology, İstanbul University İstanbul Faculty of Medicine, 34390, Çapa, İstanbul, Turkey. mine.sezgin@istanbul.edu.tr.
Background And Aim:
Medial medullary infarction (MMI) is a rare type of posterior circulation stroke. We aim to examine the clinical and radiological features, etiology, and prognosis of patients with MMI.
Method:
MMI patients registered consecutively in the stroke databank of the Istanbul Medical Faculty between January 1999 and April 2022 were included in the study. Medullary lesions were rostrocaudally classified as rostral, middle, and caudal, and ventrodorsally as ventral, middle, and dorsal. The etiological classification was performed, and functional outcome was assessed based on the modified Rankin Scale (mRS). Overall survival was estimated using the Kaplan-Meier technique.
Results:
We examined 48 cases of MMI including 9 with bilateral MMI. There were 34 men (70%), and mean age was 62.9 (± 12.8) years. The median NIHSS score was 7 (IQR; 4.5-10.5). The most common symptom was motor dysfunction. The medullary lesions were located caudally in 4 patients, rostrally in 30, rostromedially in 10, and rostro-medio-caudally in 2 patients. On ventro-dorsal classification; unilateral lesions were found ventrally in 19, ventromedially in 11, and ventro-medio-dorsally in 4 patients. The median follow-up duration was 20 months (interquartile range (IQR); 1-60). According to the third-month mRS, 39% of the patients were considered to have a good prognosis.
Conclusion:
The most common etiology was distal vertebral artery atherosclerosis. More than 50% of the patients could walk unassisted in the long-term follow-up, and stroke recurrence was infrequent. Patients with bilateral MMI had poor outcomes.
Insights
This study on medial medullary infarction (MMI) found distal vertebral artery atherosclerosis as the primary cause. Most patients achieved good long-term functional outcomes, with infrequent stroke recurrence.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Medial medullary infarction (MMI) is a rare posterior circulation stroke.
- Understanding MMI's characteristics is crucial for patient management.
Purpose of the Study:
- To analyze clinical and radiological features of MMI.
- To determine the etiology and prognosis of MMI patients.
Main Methods:
- Retrospective analysis of 48 MMI patients (1999-2022).
- Classification of medullary lesions (rostrocaudal, ventrodorsal).
- Etiological assessment and functional outcome using modified Rankin Scale (mRS).
Main Results:
- Most common etiology: distal vertebral artery atherosclerosis.
- Motor dysfunction was the predominant symptom.
- 39% had good prognosis at 3 months; 50%+ walked unassisted long-term.
Conclusions:
- Distal vertebral artery atherosclerosis is a key cause of MMI.
- MMI patients generally have favorable long-term outcomes.
- Bilateral MMI is associated with poorer prognosis.
