Sequelae of medullary infarction

Problems in any part of the body will have different symptoms. Many people must not be familiar with diseases of the medulla oblongata, especially medullary infarction, which is an uncommon disease. The effects of treatment vary from person to person, but many people will have some sequelae of medullary infarction after treatment, such as difficulty swallowing or hoarseness, which requires a period of rehabilitation treatment.

Since the medulla oblongata contains the glossopharyngeal, vagus, hypoglossal and other cranial nerve nuclei, medullary infarction may cause choking when drinking water, difficulty swallowing, hoarseness, inability to extend the tongue, and disappearance of the pharyngeal reflex. At the same time, it will affect the crossed pyramidal tracts, resulting in crossed sensory disorders, crossed motor disorders, etc. In the sequelae period of medullary infarction, patients must actively undergo rehabilitation training. At the same time, control blood pressure, blood sugar, and blood lipids, carry out secondary prevention of cerebrovascular disease, take oral aspirin to inhibit platelet aggregation and statins to stabilize plaques, and improve unhealthy lifestyles.

Medulla oblongata

Internal structure:

The internal structure of the medulla oblongata is similar to that of the spinal cord, with fiber bundles connecting the spinal cord and the brain passing through it, as well as the motor nuclei and terminal nuclei of four pairs of cranial nerves: glossopharyngeal, vagus, accessory, and hypoglossal. The relationship between the gray matter and white matter of the medulla oblongata gradually changes from the spinal cord upward. First, the pyramidal decussation appears at the lower end of the medulla oblongata, cutting off the anterior horn of the gray matter; second, the lemniscal decussation appears in the upper part of the closed segment of the medulla oblongata; third, the olive body and the rope body are formed in the open part of the medulla oblongata; fourth, the central canal opens, and the central gray matter of the spinal cord forms the gray matter of the floor of the fourth ventricle, which contains the cranial nerve nuclei; finally, the part between the gray matter of the floor of the fourth ventricle and the inferior olivary nucleus forms a reticular structure due to the separation of the gray matter by longitudinal and transverse fibers.

Physiological functions:

The main function of the medulla oblongata is to regulate visceral activities. Many basic centers necessary for maintaining life (such as respiration, circulation, digestion, etc.) are concentrated in the medulla oblongata. Once these parts are damaged, they often cause rapid death, so the medulla oblongata is known as the "life center." If the medulla oblongata remains intact, even if the upper part is damaged, functions such as breathing and circulation can still be maintained temporarily, and immediate death will not occur.

Bilateral medial medullary infarction:

1. Introduction:

The medulla oblongata is located at the lowest end of the brainstem. Because its blood supply is richer than other parts of the brainstem, the chance of medulla oblongata infarction is less than that of the pons and midbrain. Medullary infarction accounts for less than 5% of posterior circulation infarction. Medial medullary infarction is mostly related to vertebral artery occlusion, while bilateral medial medullary infarction is mostly caused by unilateral vertebral artery occlusion combined with vascular variation.

(II) Clinical manifestations:

Main symptoms and signs: weakness in the limbs, coughing when drinking water, difficulty in swallowing and dysarthria, deep and superficial paresthesia, hemiplegia, difficulty breathing and impaired consciousness.

(III) Imaging manifestations:

Plain MRI examination showed long T1 and T2 signals in the medial medulla oblongata on both sides, and high signals on diffusion-weighted imaging with a characteristic "heart-shaped" appearance.