J Clin Neurol.  2007 Dec;3(4):197-199. 10.3988/jcn.2007.3.4.197.

Ipsilateral Axial Lateropulsion as an Initial Symptom of Lateral Medullary Infarction: a Case Report

• Kim HJ
• Kwon HM
• Huh YE
• Oh MY
• Lee YS

• KMID: 1808556
• DOI: http://doi.org/10.3988/jcn.2007.3.4.197

Abstract

The dorsolateral medullary syndrome (Wallenberg's syndrome) is produced by infarction of a wedge of lateral medulla posterior to the inferior olivary nucleus, and is usually caused by vertebral artery occlusion. Ipsilateral axial lateropulsion as an initial symptom of vertebral artery occlusion is rare, and the responsible anatomical structure is still uncertain. Here we describe a patient presenting with ipsilateral axial lateropulsion as an initial symptom of vertebral artery occlusion.

Keyword

Lateral medullary syndrome; MRI

MeSH Terms

Humans
Infarction*
Lateral Medullary Syndrome
Magnetic Resonance Imaging
Olivary Nucleus
Vertebral Artery

Figure

• 

  Figure 1 Diffusion (A) and T2-weighted (B) MR images showing a high signal intensity in the right lateral medullar. MR angiography (C) disclosing severe stenosis in the distal portion of the right vertebral artery (arrow).

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  Figure 2 (A) Schematic of the anatomical structures located in the caudal medulla where the lesion was found in MRI and its sagittal level of the brainstem. The round gray areas indicate the presumed locations of the lateral vestibulospinal tract in the lower medulla oblongata, and the area with diagonal lines indicates the lesion in the patient. (B) Straight line indicates the level of the caudal medulla.

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