有位50歲的先生，發生了right pontine paramedian infarct。家屬注意到，自從中風之後，病人的表現似乎比較幼稚。您注意過這種情況嗎？
A 50-year-old gentleman suffered from a right paramedian pontine infarct. Family reported that this patient appeared a little bit childish after stroke. Did you have similar experience before?
2009年2月14日 星期六
2009年2月5日 星期四
Dysarthria clumsy hand syndrome in a patient with ankylosing spondylitis
On Feb 4, 2009, a 50-year-old man who already had ankylosing spondylitis, diabetes mellitus, hypertension, hyperlipidemia, obstructive sleep apnea syndrome and gout came to my OPD because he had suffered from dysarthria and clumsy right hand for 2 weeks. He appeared central obesity, and laboratory revealed leukocytosis (WBC count=16,000 /uL). Brain MRI disclosed a paramedian pontine infarct. There was no stenosis in major intracranial arteries (shown by MRA).
Question 1: which side of pons was infarcted to cause his symptom?
Question 2: what is the relationship between his stroke and those above-mentioned medical problems? Do you believe ankylosing spondylitis is the culprit of his pontine infarct?
Question 1: which side of pons was infarcted to cause his symptom?
Question 2: what is the relationship between his stroke and those above-mentioned medical problems? Do you believe ankylosing spondylitis is the culprit of his pontine infarct?
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