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[Acute medullary infarct: a still little know diagnosis with a poor prognosis].
Pan Afr Med J 2018; 31:85PA

Abstract

Medullary infarct is still little known influencing the short-term vital and functional prognosis of patients. Medullary vascularization is one of the most complex in the body due to the significant number of arteries that contribute to it. Our knowledge is still limited due to the scarcity of vascular medullary accidents and to low accessibility of medullary vessels during assessments. We report the case of a 62-year old patient with type 2 diabetes and a 13-year history of oral antidiabetic treatment who had been followed-up for psoriasis for 4 years. He presented to hospital in the night with his son due to acute onset of upper limb deficit. This deficit was preceded by acute onset of neck pain during his daily prayer. On admission, the patient was conscious, arterial pressure 120/86mmhg, heart rate 89 beat/min, afebrile. Clinical examination showed flaccid brachial diplegia. There was no sensory disorder or sphincteric disorder and cranial nerve examination was normal. Emergency medullary MRI was performed which showed T2 hyperintense signal and "snake-eyes"-like bilateral central dissemination (A and B). Etiological assessment showed therosclerotic patches at the origin of the left internal carotid artery. The diagnosis of myocardial infarct associated with medullary fibrocartilaginous embolism was retained. Functional rehabilitation was started early as well as treatment with platelet aggregation inhibiting drugs.

Authors+Show Affiliations

Service de Neurologie, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc.Service de Neurologie, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc.

Pub Type(s)

Case Reports
Journal Article

Language

fre

PubMed ID

31011386

Citation

Mnaili, Mohamed Amine, and Ahmed Bourazza. "[Acute Medullary Infarct: a Still Little Know Diagnosis With a Poor Prognosis]." The Pan African Medical Journal, vol. 31, 2018, p. 85.
Mnaili MA, Bourazza A. [Acute medullary infarct: a still little know diagnosis with a poor prognosis]. Pan Afr Med J. 2018;31:85.
Mnaili, M. A., & Bourazza, A. (2018). [Acute medullary infarct: a still little know diagnosis with a poor prognosis]. The Pan African Medical Journal, 31, p. 85. doi:10.11604/pamj.2018.31.85.16854.
Mnaili MA, Bourazza A. [Acute Medullary Infarct: a Still Little Know Diagnosis With a Poor Prognosis]. Pan Afr Med J. 2018;31:85. PubMed PMID: 31011386.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Acute medullary infarct: a still little know diagnosis with a poor prognosis]. AU - Mnaili,Mohamed Amine, AU - Bourazza,Ahmed, Y1 - 2018/10/04/ PY - 2018/08/16/received PY - 2018/09/24/accepted PY - 2019/4/24/entrez PY - 2019/4/24/pubmed PY - 2019/5/1/medline KW - Medullary infarct KW - acute medullary syndrome KW - fibrocartilaginous embolism SP - 85 EP - 85 JF - The Pan African medical journal JO - Pan Afr Med J VL - 31 N2 - Medullary infarct is still little known influencing the short-term vital and functional prognosis of patients. Medullary vascularization is one of the most complex in the body due to the significant number of arteries that contribute to it. Our knowledge is still limited due to the scarcity of vascular medullary accidents and to low accessibility of medullary vessels during assessments. We report the case of a 62-year old patient with type 2 diabetes and a 13-year history of oral antidiabetic treatment who had been followed-up for psoriasis for 4 years. He presented to hospital in the night with his son due to acute onset of upper limb deficit. This deficit was preceded by acute onset of neck pain during his daily prayer. On admission, the patient was conscious, arterial pressure 120/86mmhg, heart rate 89 beat/min, afebrile. Clinical examination showed flaccid brachial diplegia. There was no sensory disorder or sphincteric disorder and cranial nerve examination was normal. Emergency medullary MRI was performed which showed T2 hyperintense signal and "snake-eyes"-like bilateral central dissemination (A and B). Etiological assessment showed therosclerotic patches at the origin of the left internal carotid artery. The diagnosis of myocardial infarct associated with medullary fibrocartilaginous embolism was retained. Functional rehabilitation was started early as well as treatment with platelet aggregation inhibiting drugs. SN - 1937-8688 UR - https://www.unboundmedicine.com/medline/citation/31011386/[Acute_medullary_infarct:_a_still_little_know_diagnosis_with_a_poor_prognosis] L2 - http://www.panafrican-med-journal.com/content/article/31/85/full/ DB - PRIME DP - Unbound Medicine ER -