scholarly journals Pure Motor Monoparesis in the Leg due to a Lateral Medullary Infarction

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Hiromasa Tsuda ◽  
Kozue Tanaka ◽  
Shuji Kishida
Keyword(s):  
Magnetic Resonance ◽  
Corticospinal Tract ◽  
Antiplatelet Agent ◽  
Left Vertebral Artery ◽  
Resonance Imaging ◽  
Lateral Medullary Infarction ◽  
Leg Weakness ◽  
Normal Strength ◽  
Pure Motor ◽  
Medullary Infarction

A 76-year-old man with essential hypertension abruptly presented with slight left-sided leg weakness, despite normal strength in the other extremities. Left-sided Babinski's reflex was detected. There were no other neurologic abnormalities. Cranial magnetic resonance imaging demonstrated a small infarction in the lower lateral medulla oblongata on the left side. Cranial magnetic resonance angiography demonstrated an absence of flow of the left vertebral artery. He became asymptomatic within 10 days under intravenous antiplatelet agent. The corticospinal tract fibers innervating the lower extremity caudal to the pyramidal decussation might be involved. We emphasize that this is a first reported case of pure motor monoparesis in the leg due to lateral medullary infarction.

scholarly journals The course of facial corticobulbar tract fibers in the dorsolateral medulla oblongata

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takamichi Kanbayashi ◽  
Masahiro Sonoo
Keyword(s):  
Corticospinal Tract ◽  
Ventral Part ◽  
Imaging Findings ◽  
Facial Nucleus ◽  
Resonance Imaging ◽  
Middle Portion ◽  
Facial Paresis ◽  
Lateral Medullary Infarction ◽  
Corticobulbar Tract ◽  
Medullary Infarction

Abstract Background The course of the corticobulbar tract (CBT) to the facial nucleus has been investigated by some previous studies. However, there are some unclear points of the course of the CBT to the facial nucleus. This study aimed to elucidate the detailed course of the CBT to the facial nucleus through the analysis of lateral medullary infarction (LMI) cases. Methods The neurological characteristics and magnetic resonance imaging findings of 33 consecutive patients with LMI were evaluated. The location of the lesions was classified rostro-caudally (upper, middle, or lower) and horizontally. Further, we compared the neurological characteristics between the groups with and without central facial paresis (FP). Results Eight (24%) patients with central FP ipsilateral to the lesion were identified. Dysphagia and hiccups were more frequently observed in the group with central FP than in the group without central FP. In patients with central FP, middle medullary lesions and those including the ventral part of the dorsolateral medulla were more frequently observed. Contrastingly, patients with lesions restricted to the lateral and dorsal regions of the dorsolateral medulla did not present with central FP. Conclusion The results of this study indicate that the CBT to the facial nucleus descends with the corticospinal tract at least to the middle portion of the medulla, and then ascends to the facial nucleus through the medial and ventral areas of the dorsolateral medulla after decussation.

scholarly journals A patient with bilateral medial medullary infarction: Clinical and magnetic resonance imaging findings

2021 ◽  
Vol 25 ◽  
pp. 101126
Author(s):  
Rikitaro Sako ◽  
Satoshi Yamamoto ◽  
Kotaro Takeda ◽  
Masahiro Wakatabi ◽  
Minoru Daira ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Medial Medullary Infarction ◽  
Medullary Infarction

Changes in the corticospinal tract after wearing prosthesis in bilateral transtibial amputation

2017 ◽  
Vol 41 (5) ◽  
pp. 507-511
Author(s):  
Sang Yoon Lee ◽  
Si Hyun Kang ◽  
Don-Kyu Kim ◽  
Kyung Mook Seo ◽  
Hee Joon Ro ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diffusion Tensor Imaging ◽  
Magnetic Resonance ◽  
Primary Motor Cortex ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Transtibial Amputation

Background:After amputation, the brain is known to be reorganized especially in the primary motor cortex. We report a case to show changes in the corticospinal tract in a patient with serial bilateral transtibial amputations using diffusion tensor imaging.Case Description and Methods:A 78-year-old man had a transtibial amputation on his left side in 2008 and he underwent a right transtibial amputation in 2011. An initial brain magnetic resonance imaging with a diffusion tensor imaging was performed before starting rehabilitation on his right transtibial prosthesis, and a follow-up magnetic resonance imaging with diffusion tensor imaging was performed 2 years after this.Findings and Outcomes:In the initial diffusion tensor imaging, the number of fiber lines in his right corticospinal tract was larger than that in his left corticospinal tract. At follow-up diffusion tensor imaging, there was no definite difference in the number of fiber lines between both corticospinal tracts.Conclusion:We found that side-to-side corticospinal tract differences were equalized after using bilateral prostheses.Clinical relevanceThis case report suggests that diffusion tensor imaging tractography could be a useful method to understand corticomotor reorganization after using prosthesis in transtibial amputation.

Intraoperative Motor Evoked Potential Alteration in Intracranial Tumor Surgery and Its Relation to Signal Alteration in Postoperative Magnetic Resonance Imaging

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 302-313 ◽  
Author(s):  
Andrea Szelényi ◽  
Elke Hattingen ◽  
Stefan Weidauer ◽  
Volker Seifert ◽  
Ulf Ziemann
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Motor Cortex ◽  
Evoked Potential ◽  
Corticospinal Tract ◽  
Motor Evoked Potential ◽  
Motor Deficit ◽  
Warning Sign ◽  
Precentral Gyrus ◽  
Resonance Imaging

Abstract OBJECTIVE To determine the degree to which the pattern of intraoperative isolated, unilateral alteration of motor evoked potential (MEP) in intracranial surgery was related to motor outcome and location of new postoperative signal alterations on magnetic resonance imaging (MRI). METHODS In 29 patients (age, 42.8 ± 18.2 years; 15 female patients; 25 supratentorial, 4 infratentorial procedures), intraoperative MEP alterations in isolation (without significant alteration in other evoked potential modalities) were classified as deterioration (> 50% amplitude decrease and/or motor threshold increase) or loss, respectively, or reversible and irreversible. Postoperative MRI was described for the location and type of new signal alteration. RESULTS New motor deficit was present in all 5 patients with irreversible MEP loss, in 7 of 10 patients with irreversible MEP deterioration, in 1 of 6 patients with reversible MEP loss, and in 0 of 8 patients with reversible MEP deterioration. Irreversible compared with reversible MEP alteration was significantly more often correlated with postoperative motor deficit (P < .0001). In 20 patients, 22 new signal alterations affected 29 various locations (precentral gyrus, n = 5; corticospinal tract, n = 19). Irreversible MEP alteration was more often associated with postoperative new signal alteration in MRI compared with reversible MEP alteration (P = .02). MEP loss was significantly more often associated with subcortically located new signal alteration (P = .006). MEP deterioration was significantly more often followed by new signal alterations located in the precentral gyrus (P = .04). CONCLUSION MEP loss bears a higher risk than MEP deterioration for postoperative motor deficit resulting from subcortical postoperative MR changes in the corticospinal tract. In contrast, MEP deterioration points to motor cortex lesion. Thus, even MEP deterioration should be considered a warning sign if surgery close to the motor cortex is performed.

Neural Correlates of Hiccups in Patients with Lateral Medullary Infarction

2021 ◽  
pp. 097275312110237
Author(s):  
Appaswamy Thirumal Prabhakar ◽  
Tephilah Rabi ◽  
Atif I. A. Shaikh ◽  
Sanjith Aaron ◽  
Rohit Benjamin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Neural Correlates ◽  
Permutation Testing ◽  
Resonance Imaging ◽  
Lateral Medullary Infarction ◽  
Lateral Region ◽  
Mapping Analysis ◽  
Lesion Symptom Mapping ◽  
The Brain ◽  
Medullary Infarction

Background Hiccups is a known presentation of lateral medullary infarction. However, the region in the medulla associated with this finding is not clearly known. In this study, we aimed to study the neural correlates of hiccups in patients with lateral medullary infarction (LMI). Materials and Methods This retrospective study included all patients who presented with lateral medullary infarction between January 2008 and May 2018. Patients with hiccups following LMI were identified as cases and those with no hiccups but who had LMI were taken as controls. The magnetic resonance imaging of the brain was done viewed and individual lesions were mapped manually to the template brain. Voxel-based lesion-symptom mapping employing nonparametric permutation testing was performed using MRIcron. Results There were a total of 31 patients with LMI who presented to the hospital during the study period. There were 11 (35.5%) patients with hiccups. Using the voxel-based lesion-symptom mapping analysis, the dorso-lateral region of the middle medulla showed significant association with hiccups. Conclusion In patients with LMI, we postulate that damage to the dorsolateral aspect on the middle medulla could result in hiccups.

Sign in / Sign up

Export Citation Format

Share Document