![]() respiratory failure (especially during sleep).WHAT ELSE ARE WE WORRIED ABOUT?Īutonomic dysfunction may develop and may result in: Prevention may be difficult in most cases, however avoiding the development of atherosclerosis initially may prevent some cases of Wallenberg syndrome. The level of the lateral medullary infarct will dictate prognosis in patients, however irreversibly infarcted tissue will result in permeant damage and loss of neurological function. The MRI angiography study above shows the casual lesion in a patient with Wallenberg syndrome ( source) HOW DO WE TREAT IT?Īnti-platelet therapy with medications such as aspirin and clopidogrel are often the initial management for patients with ischemic stroke or transient ischemic attack associated with extracranial vertebral atherosclerosis. MRI can confirm the clinical diagnosis characterized above by visualizing the infarction. Ipsilateral facial pain and temperature (sensory signs and symptoms only).Contralateral loss of pain and temperature in the torso/extremities.Sensory deficits will be present in a very unique distribution relative to the site of the occlusion: Diplopia may be experienced by the patient during the eye exam.Nystagmus can be observed when testing ocular movements.Horner syndrome can be caused by this condition. A classic triad of unilateral symptoms (ptosis, anhidrosis, and miosis) might be seen.General observation: dysphagia may be observed when speaking with the patient. ![]() Nature of vertigo: patients will fall to the side of the lesion. Onset of symptoms will be sudden (given the pathophysiology of this condition) Anatomy of Wallenberg syndrome ( source) WHAT MAKES US SUSPECT IT? WHY IS IT A PROBLEM?īlockage of the PICA (or the vertebral artery which is upstream) will lead to infarction of the lateral medulla which will result in neurological deficits (explained more below). This condition is often caused by thrombosis or embolism, however other causes such as syphilitic arteritis and vertebral artery dissection are also possible. Wallenberg syndrome (lateral medullary syndrome/stroke) refers to a cerebrovascular occlusion that occurs in either the vertebral artery or the posterior inferior cerebral artery (PICA).
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