Clinical symptoms and etiological classification in patients with isolated midbrain infarction / 中国脑血管病杂志

ABSTRACT

Objective To investigate the clinical manifestations,imaging features,and etiological classification in patients with isolated midbrain infarction. Methods From December 2013 to January 2017,40 consecutive patients with isolated midbrain infarction admitted to the Department of Neurology, General Hospital of Shenyang Military Command were enrolled retrospectively. The general data,clinical and imaging data of the patients were analyzed retrospectively. According to the vascular control range and MRI characteristics,the midbrain infarcts were divided into anteromedial,anterolateral,lateral and dorsal infarcts . The differences of baseline data,clinical manifestation and etiological typing of various types of patients were analyzed. Results In the 40 patients,23 were anteriomedial infarction,14 were anterolateral infarction, 1 was lateral infarction,and 2 were mixed location infarction,0 was dorsal infarction. The common signs were dysarthria in 23 cases (57. 5%),limb and／or gait ataxia in 18 cases (45. 0%),oculomotor disturbances and／or ptosis in 15 cases (37. 5%),and limb movement disorders in 14 cases (35. 0%). The differences were statistically significant in central facial paralysis and／or lingual paralysis (3／23 vs. 8／17 ),oculomotor disturbances (15／23 vs. 0 ),and etiological types between the patients with anterior medial infarction and those infarction at other sites (all P＜0. 05). Of the 40 patients,38 had a short-term good prognosis (95. 0%)and 2 had poor prognosis (5. 0%). Conclusions Isolated midbrain infarcts mainly manifested as dysarthria,ataxia,and oculomotor disturbances. Oculomotor disturbances occurred in anteromedial infarction. The common causes of anteromedial infarction are large atherosclerosis and small vascular lesions,while the cause of infarction in other sites is often large atherosclerosis.