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J Korean Bal Soc > Volume 5(2); 2006 > Article
Journal of the Korean Balance Society 2006;5(2): 224-228.
고립성 뇌교 경색의 대표 증상으로서의 측방 돌진
, , 김현아1,2, 이형1,2, 박병림3,4
계명대학교 의과대학 신경과학교실1,2, 원광대학교 의과대학 생리학교실3,4
Body Lateropulsion as an Isolated or Predominant Symptom of a Pontine Infarction
Hyun Ah Kim, Hyung Lee, Byung Rim Park
1Department of Neurology, Keimyung University School of Medicine, Daegu, Korea. hlee@dsmc.or.kr
2Brain Research Institute, Keimyung University School of Medicine, Daegu, Korea.
3Department of Physiology, Wonkwang University School of Medicine, Iksan, Korea.
4Medicine and Hanbang Brain Disease Research Center, Wonkwang University School of Medicine, Iksan, Korea.
Background and Objectives:   Body lateropulsion with falling to one side is a well-known clinical feature of stroke in the posterior circulation. Body lateropulsion as an isolated or predominant manifestation of a pontine stroke has not previously been reported. To elucidate the possible mechanisms of patients presenting with body lateropulsion as an isolated or predominant symptom of isolated pontine infarction.
Materials and Method:   Between May 2004 and February 2006, out of 134 admitted patients with an isolated pontine stroke we identified 8 consecutive patients (6.0%) in the Keimyung University Stroke Registry who had body lateropulsion as the main presenting symptom.
Results:   All lesions were localized to the paramedian tegmentum just ventral to the 4th ventricle. All except 1showed a uniform pattern of body lateropulsion, in which the direction of falling was away from the side of infarct. In 2 patients, body lateropulsion was the sole clinical manifestation, whereas the other patients had other neurological signs. All but 1 had contraversive tilting of the subjective visual vertical (SVV). In all cases, the direction of SVV tilt corresponded to the direction of body lateropulsion. The mean net tilt angle was 6.1
Conclusion:   Based on the known anatomy of ascending vestibular pathways, the SVV tilting, and MRI findings, body lateropulsion probably results from damage to the graviceptive pathway ascending through paramedian pontine tegmentum. Key Words : Pons, Infarction
Keywords: Pons; Infarction
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