Brain Stem Stroke: Clinical, Magnetic Resonance Imaging and Etiological Patterns

[摘要] Background: Patients with brain stem strokes show variable outcomes; some may show severe disability or even die while others show mild functional or cognitive disturbances less than those of hemispheric strokes. Objective: To determine the risk factors of the brain stem stroke and to assess the outcome of it. Methods: This study included 76 patients with first ever brain stem cerebrovascular strokes [46 (61%) patients with infarction, and 30 (39%) with hemorrhage]. Each patient was subjected to full history taking and neurological examination, laboratory investigations for risk factors, ECG, Echocardiography, brain CT scan and/or MRI on admission. Severity and functional outcome of stroke was assessed using outcome scales; National Institute of Health Stroke Scale (NIHSS) and Barthel Index scale on admission, and reassessed after 1 month and 3 months. Results: Diabetes mellitus and hypertension were significantly higher in hemorrhagic group, while transient ischemic attack (TIA) was significantly higher in infarction group. Coma and death were higher in hemorrhagic group. Both groups showed improvement in the degree of the neurological impairment on (NIHSS & Barthel Index), but with no significant difference at 1 month and with significant difference at 3 months for hemorrhagic rather than infarction group. Conclusion:  Outcome after brainstem stroke is variable; death was higher in hemorrhagic group. Both groups showed improvement of the neurological impairment which was better in the hemorrhagic rather than infarction group especially at 3 months. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 137-145)

[学科分类] 精神健康和精神病学