Abstract
Background and Purpose The initial diagnosis of medullary infarction can be challenging since CT and even MRI results in the very acute phase are often negative. Methods A retrospective, observer-blinded study of horizontal conjugate eye deviation was performed in 1) 50 consecutive patients [age 58 +/- 15 years (mean +/- SD), 74% male, National Institutes of Health Stroke Scale 2 +/- 1] with acute unilateral lateral medullary infarction as seen in MRI (infarction group), 2) 54 patients with transient brainstem symptoms [transient ischemic attack of brainstem (TIA) group;age 69 +/- 16 years, 59% male], and 3) 53 patients (age 59 +/- 20 years, 49% male) with diagnoses other than stroke (control group). Results Conjugate eye deviation was found in all patients in the infarction group [n=47 (94%) with ipsilesional deviation and n=3 (6%) with contralesional deviation] compared to 41% (n=22) in the brainstem TIA group and 15% (n=8) in the control group (p<0.0001). Within all groups mean deviation and range were similar for both sides (to the right vs. to the left side 26.6 degrees +/- 12.3 vs. 26.1 degrees +/- 12.3 in the infarction group, 10.5 degrees +/- 5.8 vs. 8.4 degrees +/- 6.3 in the brainstem TIA group and 4.5 degrees +/- 3.2 vs. 7.5 degrees +/- 3.2 in the control group). The extent of eye deviation was significantly greater in the infarction group (p<0.05). Conclusions All patients with MRI-demonstrated unilateral medullary infarction showed conjugate eye deviation. Therefore, conjugate eye deviation in patients with suspected acute lateral medullary infarction is a helpful sensitive sign for supporting the diagnosis, particularly if the deviation is >20 degrees.
| Dokumententyp: | Zeitschriftenartikel |
|---|---|
| Fakultät: | Medizin |
| Themengebiete: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit |
| ISSN: | 1738-6586 |
| Sprache: | Englisch |
| Dokumenten ID: | 80200 |
| Datum der Veröffentlichung auf Open Access LMU: | 15. Dez. 2021, 14:52 |
| Letzte Änderungen: | 15. Dez. 2021, 14:52 |
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