{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T15:42:15Z","timestamp":1785858135742,"version":"3.56.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2009,10]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background and Purpose\u2014<\/jats:italic>\n            <\/jats:bold>\n            Clinical-imaging correlation and long-term clinical outcomes remain to be investigated in medial medullary infarction (MMI).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods\u2014<\/jats:italic>\n            <\/jats:bold>\n            We studied clinical, MRI, and angiographic data of 86 consecutive MMI patients. The lesions were correlated with clinical findings, and long-term outcomes, divided into mild and severe (modified Rankin scale &gt;3), were assessed by telephone interview. Central poststroke pain (CPSP) was defined as persistent pain with visual numeric scale \u22654.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            The lesions were located mostly in the rostral medulla (rostral 76%, rostral+middle 16%), while ventro-dorsal lesion patterns include ventral (V, 20%), ventral+middle (VM, 33%), and ventral+middle+dorsal (VMD, 41%). Clinical manifestations included motor dysfunction in 78 patients (91%), sensory dysfunction in 59 (73%), and vertigo\/dizziness in 51 (59%), each closely related to involvement of ventral, middle, and dorsal portions, respectively (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001, each). Vertebral artery (VA) atherosclerotic disease relevant to the infarction occurred in 53 (62%) patients, mostly producing atheromatous branch occlusion (ABO). Small vessel disease (SVD) occurred in 24 (28%) patients. ABO was more closely related to VMD (versus V+VM) than was SVD (\n            <jats:italic>P<\/jats:italic>\n            =0.035). During follow-up (mean 71 months), 11 patients died, and recurrent strokes occurred in 11. Old age (\n            <jats:italic>P<\/jats:italic>\n            =0.001) and severe motor dysfunction at admission (\n            <jats:italic>P<\/jats:italic>\n            =0.001) were factors predicting poor prognosis. CPSP, occurring in 21 patients, was closely (\n            <jats:italic>P<\/jats:italic>\n            =0.013) related to poor clinical outcome.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusion\u2014<\/jats:italic>\n            <\/jats:bold>\n            MMI usually presents with a rostral medullary lesion, with a good clinical ventro-dorsal imaging correlation, caused most frequently by ABO followed by SVD. A significant proportion of patients remain dependent or have CPSP.\n          <\/jats:p>","DOI":"10.1161\/strokeaha.109.559864","type":"journal-article","created":{"date-parts":[[2009,7,24]],"date-time":"2009-07-24T02:06:05Z","timestamp":1248401165000},"page":"3221-3225","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":115,"title":["Medial Medullary Infarction"],"prefix":"10.1161","volume":"40","author":[{"given":"Jong S.","family":"Kim","sequence":"first","affiliation":[{"name":"From the Stroke Center and Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young S.","family":"Han","sequence":"additional","affiliation":[{"name":"From the Stroke Center and Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-190812000-00003"},{"key":"e_1_3_2_2_2","unstructured":"Dejerine J. Semiologie des affections du syst\u00e8me nerveux. Paris: Masson: 1914: 226\u2013230."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneurpsyc.1937.02260130101007"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.9.1548"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.47.5.1141"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.4.882"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00007852"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.30.12.2697"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000095753"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awg169"},{"key":"e_1_3_2_11_2","unstructured":"Parent A. Carpenter\u2019s Human Neuroanatomy 9th ed. Baltimore: Williams & Wilkins; 1996: 421\u2013458."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1159\/000210433"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.39.9.1246"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/81.3.364"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.6.837"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.49.1.120"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000180627.80595.10"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000110186.05217.9B"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.109.559864","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T08:32:18Z","timestamp":1738830738000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.109.559864"}},"subtitle":["Clinical, Imaging, and Outcome Study in 86 Consecutive Patients"],"short-title":[],"issued":{"date-parts":[[2009,10]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2009,10]]}},"alternative-id":["10.1161\/STROKEAHA.109.559864"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.109.559864","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,10]]},"assertion":[{"value":"2009-06-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-06-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}