脑干急性梗死所致前核间性眼肌麻痹临床与影像特征分析

目的：研究脑干急性梗死所致前核间性眼肌麻痹的临床及影像特点。方法：回顾性研究4例前核间性眼肌麻痹的临床资料、影像资料及治疗结果并结合解剖学知识进行分析。结果：本组4例全部为缺血性脑血管病患者,在进行常规磁共振扫描后2例进行脑干薄层扫描,全部发现在脑桥上部背侧及四脑室顶端腹侧并靠近中线位置存在点状梗死灶。4例患者治疗后,1例治愈,3例眼球内收改善且复视明显好转。结论：前核间性眼肌麻痹存在其特有的影像学特点。头颅核磁共振均表现为脑桥上部背侧,四脑室顶端腹侧内侧纵束部位点状异常信号；脑干薄层扫描可提高病灶检出率。

Acute brain stem infarction-induced anterior internuclear ophthalmoplegia: clinical and imaging features of 4 cases

Objective To investigate the clinical and radiographic features of anterior internuclear ophthalmoplegia caused by acute brainstem infarction. Methods Four cases of anterior internuclear ophthalmoplegia were retrospectively reviewed by analyzing their clinical and radiographic data together with anatomical features. Results All 4 cases were caused by brainstem ischemic lesions, demonstrating dotted infraction on thin-sliced diffused-weighted imaging at the dorsal side of pontine and the ventromedial side of the fourth ventricle. Among 4 cases, 1 was cured and the other 3 cases achieved improved adduction and diplopia. Conclusion Anterior internuclear ophthalmoplegia is characterized by its dotted lesion in the brainstem at the dorsal side of pontine and the ventromedial side of the fourth ventricle. Thin-sliced MRI facilitates the detection of these lesions.