Select the file that you have just downloaded and select import option Reference Manager (RIS). Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature.
Wallenburg pica syndrome step 1 Activator#
The Use of Tissue Plasminogen Activator in the Treatment of Wallenberg Syndrome Caused by Vertebral Artery Dissection. J Emerg Med. 2017 May 52(5):738-740.Miao HL, Zhang DY, Wang T, Jiao XT, Jiao LQ. Clinical Neurology and Neuroanatomy: A Localization-Based Approach New York, NY: McGraw-Hill. Journal of Neurology, Neurosurgery & Psychiatry 1991 54:549-550. (1988), Torsional nystagmus in the lateral medullary syndrome. Lateral medullary ischaemic events in young adults with hypoplastic vertebral artery. J. ↑ Giannopoulos S, Markoula S, Kosmidou M, Pelidou SH, Kyritsis AP.Headache: The Journal of Head and Face Pain, 44: 70-74. (2004), Lateral Medullary Infarction Secondary to Vertebral Artery Dissection Presenting as a Trigeminal Autonomic Cephalalgia. ↑ Galende, A.V., Camacho, A., Gomez‐Escalonilla, C., Penas, M., Juntas, R., Ramos, A.Clinical study of 46 patients with lateral medullary infarction. J Stroke Cerebrovasc Dis. 2015 May 24(5):1065-74.
↑ 2.0 2.1 2.2 Ogawa K, Suzuki Y, Oishi M, Kamei S. Treasure Island (FL): StatPearls Publishing 2020 Jan. Optical therapy, using eye patches or prisms, has been used to alleviate unresolved diplopia. Long term ophthalmic care after WS are designed to improve visual symptoms. Because this condition is caused by a stroke of the brainstem, the use of intravenous tissue-type plasminogen activator can be used if administered within 4-5 hours of symptom onset. Because it is almost always caused by a stroke, treatment is time dependent. Treatment for WS depends on its etiology. Ipsilateral loss of pain and temperature of faceĬontralateral loss of pain and temperature of bodyĭifficulty swallowing, elevating palate, hoarseness, dysphagiaĭifficulty with taste and processing visceral sensory info Minor loss of vestibulomotor coordination Table 1: Neurological manifestations due to lesions of structures of the medulla - specific structures affected and their manifestations of Wallenberg syndrome are listed in boldĬontralateral loss of vibration and proprioception of body Binocular oblique diplopia – secondary to skew deviation from disruption of otolithic input at the level of the brainstem. Oscillopsia due to rotary nystagmus – due to disruption of communicating neurons between brainstem and inferior cerebellar peduncle patient experiences oscillopsia, nausea, vomiting, vertigo, dizziness. Horner syndrome (miosis, ptosis, upside down ptosis, anhidrosis)– due to disruption of the oculosympathetic chain, which descends through the lateral medulla. Other rarer causes such as vertebral artery dissection especially in predisposed younger individuals with Ehlers Danlos syndrome, Marfan syndrome, fibromuscular dysplasia and hypoplastic vertebral artery have been noted in prior literature. Primary etiologies include atherosclerosis, hypertension and other vasculopathic risk factors. While most commonly due to PICA occlusion, other arteries, such as the vertebral artery or branches of PICA, can be involved as well. WS is most commonly due to an occlusion of the PICA, resulting in ischemia and infarction of the lateral medulla. The blood flow and the cross-sectional anatomy of the medulla are illustrated in figures 1 and 2.įigure 2: cross-sectional anatomy of medulla including all nuclei and tracts Etiology The anterior spinal artery has its own median medullary branch, which perfuses the anteromedial region of the medulla. The anterior spinal artery provides blood flow to the remainder of the medulla. 
The medial medullary branch of PICA perfuses the anterior lateral medulla, and the lateral medullary branch perfuses the lateral medulla. The dorsal medullary branch of PICA perfuses the posterior medulla.
The vertebral artery supplies the posterior inferior cerebellar artery (PICA), which has 3 main branches: the dorsal, medial, and lateral medullary branches. The primary blood supply to the medulla comes from the vertebral arteries. These regions are divided based on their differing arterial supply. The medulla can be divided into 4 regions: anteromedial, anterolateral, lateral, and posterior ( Figure 1). This monograph highlights the neuro-ophthalmic presentations for the WS. WS is typically due to ischemia from a vertebral artery or posterior inferior cerebellar artery infarction. Wallenberg syndrome (WS) is a neurological disorder that is due to damage to the lateral portion of the medulla oblongata (i.e., the lateral medullary syndrome).
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