피질하 및 뇌교 뇌경색에 의한 순수 구음장애: 확산강도 영상을 이용한 병소분석

Abstract

Pure dysarthria is a type of lacunar infarction. Because previous studies described mainly to the dysarthric patients with central facial paresis or clumsy hand, pure dysarthria without facial paresis or other neurologic deficits, especially in subcortical or pontine infarction, was rare. We studied the patients with subcortical or pontine infarction who presented isolated dysarthria. Among 1, 176 patients with acute stroke collected by the Keimyung Stroke Registry from March 2003 to February 2005, we selected 11 patients who presented with pure dysarthria due to subcortical or pontine infarctions. We identified lesions by diffusion-weighted MRI (DWI), and analyzed cerebrovascular risk factors, lesion locations and prognosis. DWI demonstrated small high signal lesions in the centrum semiovale (n=2), corona radiate (n=3), internal capsule (n=3), and pons (n=3). The most common risk factor for the ischemic stroke with pure dysarthria was hypertension. The lesions mostly located in the left hemisphere. All subjects showed a good recovery from dysarthria. Infarcts causing dysarthria in all patients located along the course of the corticobulbar tract and showed left-sided predominance in supratentorial lesion. Pure dysarthria due to internal capsule lesion could bo caused by a small lesion in the anterior portion of posterior limb.