초록 열기/닫기 버튼
Background : Facial weakness of supranuclear type has been reported in patients with lower brainstem lesions including medullary infarction. It suggests that an aberrant pathway of cortico-bulbar fibers to the pontine facial nucleus may exist in the lower brainstem. In order to investigate the aberrant pathway, we evaluated the lesion location of lower brainstem infarction presenting facial weakness of supranuclear type. Methods : We evaluated MRI findings of 10 patients with facial weakness of supranuclear type due to the infarction of mid-lower pons or medulla oblongata. Results : In 8 patients with pontine infarction, the lesions were located in the paramedian area on the side contralateral to facial weakness. In 2 patients with medullary infarction, the lesions were located in the dorsolateral area on the side ipsilateral to facial weakness: one at the rostral level, the other at the caudal level. Conclusions : These observations suggest that the facial cortico- bulbar fiber tract runs through the paramedian region of lower pons and down to the rostral or caudal part of medulla oblongata, which crosses toward the contralateral caudal dorsolateral medulla, making a loop, and then ascends up to the lower facial portion of the facial nucleus. Korean Journal of Stroke 2000;2(1): 48~52
