Progression rates of medulla oblongata infarcts in clinical follow-up: A retrospective study

Clin Neurol Neurosurg. 2022 Aug:219:107329. doi: 10.1016/j.clineuro.2022.107329. Epub 2022 Jun 6.

Abstract

Objective: To determine clinical progression rates in patients with medulla oblongata infarction (MOI).

Materials and methods: The data of patients diagnosed with MOI were analysed retrospectively. Dermographic characteristics of the patients; Age, gender, history and stroke etiology were evaluated. Radiological imagings were reviewed retrospectively. Intensive care unit (ICU) requirement, number of intubation days, failed extubation and death rates, good clinical outcome at discharge and 3 months [modified Rankin Scale (mRS 0-2)] and poor clinical outcome (mRS 3-6) rates were evaluated. In addition, the clinical results of patients with medial medullary infarction (MMI) and lateral medullary infarction (LMI) were compared.

Results: 33 patients were included in the study, 22 (66.7 %) were male. The mean age of the patients was 72.0 (43.0-85.0). The characteristics of the patients (dermographic features, comorbidities, clinical symptoms, infarct localization, etc.) were evaluated. The results of MMI and LMI patients were compared. The intubation rate was 4 (44.4 %) in the MME group, while it was 8 (33.3 %) in the LME group. There was no statistically significant difference between the two groups in terms of failed extubation, tracheostomy, hospitalization and mortality rates. However, while discharge mRS was statistically significant between the two groups, the mRS at 3 months was not statistically significant. Twelve (36.4 %) of all patients were intubated due to severe clinical progression. In the clinical follow-up, 6 (50.0 %) of the intubated patients died, 3rd month mRS of 6 (50.0 %) patients who survived was 5. In all patients 3-month good clinical outcome rate was % 48,5.

Conclusion: It should not be forgotten that life-threatening clinical progressions may develop at a considerable rate during the early treatment process of patients diagnosed with MOI.

Keywords: Medulla oblongata infarction; Neurology intensive care.

MeSH terms

  • Brain Stem Infarctions* / diagnosis
  • Female
  • Humans
  • Infarction
  • Male
  • Medulla Oblongata / diagnostic imaging
  • Retrospective Studies
  • Stroke*
  • Treatment Outcome