1999 Volume 3 Issue 2 Pages 10-15
The subjects studied were 10 patients who were diagnosed with lateral medullary infarction according to the results of magnetic resonance imaging (MRI). They consisted of seven males and three females and their mean age was 58.3 years． Dysphagic symptoms were severe in four patients and mild in four patients． The remaining two patients showed no dysphagic symptoms． Two patients who needed tube feeding were discharged from this hospital． The patient who showed the most severe symptoms was placed on conservative therapy for four months after the onset of this disease． Fortunately the conservative therapy was effective for the improvement of symptoms and oral feeding was initiated． Except for dysphagia， no difficulties were recognized in the activity of daily living in all the cases except for dysphagia． MRI revealed the lesion in the medial part of the lateral portion of medulla oblongata in four cases of severe dysphagia， Regarding the etiology of lateral medullary infarction， thrombosis was recognized in six cases and the dissection of vertebral artery (VA) in four cases． The latter patient group were younger and at lower risk of cerebral infarction than the former patient group． Three of four patients with severe dysphagia suffered from VA dissection． VA dissection， which was regarded as the causative factor in about half of the cases of lateral medullary infarction， was recognized in most of the patients with severe dysphagia． The movement of head and neck should be carefully controlled in the cases of VA dissection． lt is of prime importance to identify the etiology of lateral medullary infarction and to establish the adequate treatment strategy at its early stage．
