dc.description.abstract | There is a low incidence of the medullary infarctions and sparse data about
the vascular territories, as well as a correlation among the anatomic, magnetic resonance
imaging (MRI) and neurologic signs. Materials and methods: Arteries of the 10 right and
left sides of the brain stem were injected with India ink, fixed in formalin and microdissected. The enrolled 34 patients with medullary infarctions underwent a neurologic,
MRI and Doppler examination. Results: Four types of the infarctions were distinguished
according to the involved vascular territories. The isolated medial medullary infarctions
(MMIs) were present in 14.7%. The complete MMIs comprised one bilateral infarction
(2.9%), whilst the incomplete and partial MMIs were observed in 5.9% and 8.9%, respectively. The anterolateral infarctions (ALMIs) were very rare (2.9%). The complete and
incomplete lateral infarctions (LMIs), noted in 35.3%, comprised 11.8% and 23.6%,
respectively, that is, the anterior (5.9%), posterior (8.9%), deep (2.9%), and peripheral
(5.9%). Dorsal ischemic lesions (DMIs) occurred in 11.8%, either as a complete (2.9%), or
isolated lateral (5.9%) or medial infarctions (2.9%). The remaining ischemic regions
belonged to various combined infarctions of the MMI, ALMI, LMI and DMI (35.3%).
The infarctions most often affected the upper medulla (47.1%), middle (11.8%), or both
(29.5%). Several motor and sensory signs were manifested following infarctions, including vestibular, cerebellar, ocular, sympathetic, respiratory and auditory symptoms.
Conclusions: There was a good correlation among the vascular territories, MRI ischemia
features, and neurologic findings regarding the medullary infarctions. | sr |