关键词: 脑干梗死; 眼肌麻痹; 症状和体征

Abstract: Objective To describe the clinical features, magnetic resonance imaging(MRI) findings,pathogenesis and risk factors of stroke progression of brainstem infarction dominantly manifestedas ophthalmoplegia.Methods Thirty-two patients presenting with ophthalmoplegia with or without minimalaccompanied neurological sings were studied. To analysis the types of ophthamopoegia,accompanied neurological symptoms, responsible blood vessel and focus, pathogenesis and risks ofstroke progression.Results In 32 cases included, four types of ophthalmolegia were classified:sub-nuclear(2 cases),nuclear(21 cases), inte-rnuclear(4 cases) and mixed ophthalmoplegia(5 cases). Vertigo was the mostcommon accompanied symptom. Nine patients had multiple lesions. Vascular occlusion or stenoseswere found in 11 patients:8 at the posterior cerebral circulation, 3 at the anterior cerebral circulation.Vascular risk factors were more common in progressive stroke group than non-progressive groups.Multiple infarction lesion and accompanied neurological signs were statistically correlated withstroke progression.Conclusion Clinical features of ophthalmoplegia caused by brainstem infarction varies, in whichnuclear oculomotor nerve ophthalmoplegia was the most common type. The responsible arteryincluded both large and small blood cerebral vessels, patients with Essen Stroke Risk Score(ESRS)>3 score, multiple infarction lesions and accompanied positive neurological signs showedhigher possibilities of progression, suggesting a more aggressive prevention.

Key words: Brain stem infarctions; Ophthalmoplegia; Signs and symptons