Acute Respiratory Failure Caused by Bilateral Medial Medullary Infarction: A Case Report

雙邊內側髓腦中風引發急性呼吸衰竭：一病例報告

余宛霖(Wang-Ling Jee) ； 余柔辰(Rou-Chen Jee) ； 周義(Chew Ghee)

《Journal of Emergency Medicine, Taiwan》 11卷2期 (2009/06) Pp. 50-53

摘要

雙邊內側髓腦中風在顱內後腦循環系統所引發之中風病例中相當罕見。其典型臨床表現為舌下神經麻痺、臉部除外之全身癱瘓和深層感覺神經受影響。雙邊內側髓腦中風對於急診醫師最可怕的地方為其所引發的迅速進展的急性呼吸衰竭。其診斷的依據為腦部核磁共振檢查中彌散加權圖像出現典型的“心型”標記。即使及時給予血栓溶解劑成功舒通顱內後循環系統，其死亡率仍居高不下。成功治療的關鍵在於及時診斷、及時給予血栓溶解劑和積極的呼吸道處置。

關鍵字

呼吸衰竭 ； 中風 ； 髓腦中風

並列摘要

Bilateral medial medullary infarction (BMMI) is very rare. Typical clinical manifestations of this disease are bilateral hypoglossal nerve palsy, tetraparesis, and the disturbance of deep sensations. It can also be life-threatening due to acute respiratory failure, and is a particularly stressful situation for emergency physicians when dealing with this. A characteristic ”heart” sign is a diagnostic finding with horizontal diffusion-weighted MRI sections. The use of timely thrombolytic therapy with vertebrobasilar recanalization in patients carries a high mortality rate. However, patients with respiratory failure would survive if the occurrence of a stroke is immediately recognized, and the patient is treated with ventilator support.

並列關鍵字

respiratory failure ； stroke ； bilateral medial medullary infarction ； thrombolytic therapy ； vertebrobasilar recanalization