STROKE-PRESENTATION, LATERAL MEDULLARY SYNDROME

SUMMARY

A vertebral stroke may cause lateral medullary syndrome (also called Wallenberg syndrome; occurs due to occlusion of vertebral a., PICA, superior/middle/inferior lateral medullary a.):

1. Nausea, vomiting, nystagmus - involvement of the vestibular nucleus.

2. Ipsilateral Horner's syndrome - due to involvement of the descending sympathetic fibers.

3. Ipsilateral palate and vocal cord weakness - involvement of the nucleus ambiguus.

4. Ipsilateral cerebellar signs and symptoms: due to involvement of the inferior cerebellar peduncle and cerebellum.

5. "Crossed" sensory loss - ipsilateral face and contralateral body, due to involvement of the trigeminal nucleus and tract and spinothalamic tract, respectively.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].