Abstract
[Background and purpose] Classical medullary syndromes in patients with medullary infarctions (MIs) often display incomplete neurological manifestations. Recently, new radiological classifications employing MRI have been proposed by Kameda et al. (2004). In this study, we attempted to classify MIs based on MRI findings. [Methods] We studied 46 patients with MIs at our hospital between April 1995 and March 2005. The diagnosis of the MIs was made on the basis of the neurological findings and MRI in each case. All patients were classified into three groups based on the MRI classification system proposed by Kameda. The risk factors for the medial medullary infarction (MMI) group were compared with those for the lateral medullary infarction (LMI) group by multivariate logistic regression analysis. [Results] Twenty-one of the patients with MIs were diagnosed as showing incomplete medullary syndromes. However, there are no incomplete manifestations on the MRI classification. According to the anatomical region, we speculated that the patients diagnosed as Wallenberg syndrome could be classified mainly as beings of the dorsolateral type, and the patients diagnosed as Dejerine syndrome could be classified mainly as being of the paramedian type. However, the correlation between clinical symptoms and MRI findings may sometimes be inconsistent. The mean age of the patients with dissection of the vertebral artery was significantly younger than that of those without dissection in the LMI group (p=0.012). Diabetes mellitus was significantly associated with the MMI group (OR, 6.500; p=0.035). [Conclusion] Radiological classification of MIs may be useful for the identification of clinical-topographical correlations, and for evaluation of the pathophysiological mechanisms and risk factors in patients with MIs.
