STUDY ON CLINCAL PROFILE AND RADIOLOGICAL FEATURES IN BRAINSTEM STROKE

Abstract : AIM - To study the clinical profile and radiological features in brainstem stroke. METHODS- This study analysed the clinical features of 20 patients with acute brainstem stroke and correlated the clinical syndromes with radiological findings. RESULTS - 1)Total number of 20 patients, of which males (75 percentage) and females (25 percentage). 2) Ischemic stroke (80 percentage), haemorrhagic stroke (20 percentage). 3)The common manifestations werevertigo, sensorydisturbances, unsteadiness, cranial nerve involvement, speech disturbance in descending order. 4) The most common stroke syndrome was lateral medullary syndrome (7). Other clinical presentations were Submedullary syndrome of Opalski (1), Medial medullary syndrome (1), Pure motor hemiparesis (2), Sensory motor stroke (2), Ataxic hemiparesis (3), Quadrataxic variant of Ataxic hemiparesis (1) Raymond- cestan syndrome (1), Locked in syndrome (2). 5) MRI results showed that the large lesions located in paramedian caudal or middle pons correlate with pure motor hemiparesis. 6)Lesions producing ataxic hemiparsis were located variously. 7)Rostral medullary lesion were associated with severe dysphagia, hoarseness, and facial paresis, whereas the caudal lateral medullary lesions, correlate with marked vertigo, nystagmus, and gait ataxia. 8)Lesions extending ventromedially correlates with contralateral facial sensory impairment. 10)Nausea,vomiting and Horners syndrome were common finding regardless of the lesion location. CONCLUSION - Our data suggest that the various syndromes that follow brainstem stroke reflect the balance of the involvement of the spinal and trigeminal lemniscus, spino cerebellar, corticopontocerebellar, descending sympathetic tract and corticospinal tract.