MEDIAL MEDULLARY INFARCTION - ANALYSES OF 11 PATIENTS

Of 2,130 consecutive patients admitted to two hospitals with acute bra in infarction, we examined 11 patients (0.52%) with medial medullary i nfarction. The infarcts documented by MRI were unilateral in 9 patient s and bilateral in 2 patients, and located in the anteromedial arteria l territory of the upper or middle part of the medulla. Atherosclerosi s of the vertebral arteries was the predominant vascular pathology. Th e vertebral artery was occluded at its terminal portion in 7 patients. Nine patients had hypertension, and 8 of these had additional risk fa ctors. Male gender (10 patients) and smoking habits (7 patients) were more prevalent compared with patients with pontine infarction. One pat ient had a medial medullary infarction attributed to dissection of the vertebral arteries following blunt head injury. Limb weakness was the major symptom in all patients, and gaze-evoked nystagmus was also fre quent (6 patients). Tongue weakness ipsilateral to the infarct, the cl assic sign of medial medullary syndrome, was evident in only 3 patient s. The outcome was usually excellent.