Q 1.22. Brainstem Vascular Syndromes: Medulla Oblongata

  1. Lateral Medullary Syndrome (Wallenberg Syndrome):

    • Affected ArteryPosterior Inferior Cerebellar Artery (PICA) or its branches.
    • Clinical Manifestations:
      • Body Representation:
        • Contralateral loss of pain and temperature sensation in the arm and leg (via the spinothalamic tract).
        • Ipsilateral ataxia in the arm and leg (via the spinocerebellar tract).
        • Ipsilateral loss of pain and temperature sensation in the face (sensory nucleus of trigeminal nerve).
      • Other Features:
        • Horner’s syndrome (ipsilateral eye ptosis, anhidrosis, and miosis).
        • Vertigo, nystagmus (vestibular nucleus).
        • Loss of gag reflex (vagus nerve).
        • Dysphagia (nucleus ambiguus and glossopharyngeal nerves).
  2. Medial Medullary Syndrome (Dejerine Syndrome):

    • Affected ArteryAnterior Spinal Artery or its branches.
    • Clinical Manifestations:
      • Body Representation:
        • Contralateral weakness in the arm and leg (corticospinal tract).
        • Contralateral loss of vibration and proprioception (medial lemniscus).
      • Other Features:
        • Internuclear ophthalmoplegia (ipsilateral eye deviation during attempted lateral gaze).
        • Deviation of the tongue toward the side of the lesion (hypoglossal nerve).

These syndromes result from vascular occlusion or mass effect within the brainstem.

 

References:

(1)researchgate.net

(2)pubs.rsna.org

(3)pubmed.ncbi.nlm.nih.gov

Verifiziert von Dr. Petya Stefanova

Teilen: