J Clin Neurol.  2006 Dec;2(4):276-278. 10.3988/jcn.2006.2.4.276.

Opalski's Syndrome with Cerebellar Infarction

• Kim HY
• Koh SH
• Lee KY
• Lee YJ
• Kim SH
• Kim J
• Kim HT

• KMID: 1980470
• DOI: http://doi.org/10.3988/jcn.2006.2.4.276

Abstract

A 64-year-old man presented with sudden onset of right-sided hemiparesis, headache, gait disturbance, and recurrent vomiting. A physical examination revealed right-sided hemiparesis, right Horner syndrome, ataxia of the right limbs, and diminished sensation on the left side of his body. Diffusion-weighted MRI revealed an acute right lateral medullary infarction extending from the rostral medulla to the upper cervical cord, and an acute cerebellar infarction in the territory of the medial branch of the posterior inferior cerebellar artery. Magnetic resonance angiography revealed suspicious severe stenosis or near occlusion of the proximal and distal parts of the right vertebral artery, and hypoplasia of the left vertebral artery. We diagnosed ipsilateral hemiparesis with lateral medullary infarction (Opalski's syndrome) and concomitant cerebellar infarction.

Keyword

Opalski's syndrome; Ipsilateral hemiparesis; Cerebellar infarction

MeSH Terms

Arteries
Ataxia
Constriction, Pathologic
Extremities
Gait
Headache
Horner Syndrome
Humans
Infarction*
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Middle Aged
Paresis
Physical Examination
Sensation
Vertebral Artery
Vomiting

Figure

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  Figure 1 (A, B) Axial diffusion-weighted and T2-weighted imaging demonstrates a hyperintense area, indicating an acute brain infarction in the lateral lower medulla extending to the upper cervical cord and cerebellum.

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  Figure 2 Suspicious narrowing (arrows) of the proximal and distal portions of the right vertebral artery and suspicious hypoplasia (arrowheads) of the left vertebral artery were evident on magnetic resonance angiography.

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