Regarding the histopathological lesion, the infarct disturbed on the right side the lateral spinothalamic tract, nucleus of the spinal tract of the trigeminal nerve, spinal tract of the trigeminal nerve, spinocerebellar tract, inferior cerebellar peduncle and nucleus ambiguus.ĬONCLUSION: Based on our investigation of pathological lesions using our 2 autopsies, we suggest calling the cases that satisfy the following 3 criteria "definite pathologic Wallenberg syndrome": i) identifiable pathological obstruction of the PICA or VA ii) infarction in the lateral MO based on PICA or VA obstruction and iii) a 1-to-1 correspondence between clinical symptoms and neuropathological lesions. A pathological luminal occlusion was identified in the right PICA. Answer: History is suggestive of Wallenberg syndrome (Lateral Medullary Syndrome). In young patients under 45 years of age, vertebral artery dissection can cause 20 of strokes. Atherosclerosis is the most common cause of posterior circulation infarcts. Patient 2 showed the 3 major symptoms of right crossed sensory disturbance, right cerebellar ataxia and bulbar palsy. Vertebral artery disease is the main cause of lateral medullary syndrome, and PICA disease can cause Wallenberg syndrome as well. The left cerebellar ataxia and bulbar palsy were observed among these 3 major symptoms. Moreover, a clear infarct in the left lateral MO was pathologically identified, but pathological obstruction of the left PICA or left VA could not be found. Regarding the histopathlogical distribution, the infarct extended on the right side to the lateral spinothalamic tract, nucleus of the spinal tract of the trigeminal nerve, spinal tract of the trigeminal nerve, inferior cerebellar peduncle, spinocerebellar tract and nucleus ambiguous. There was the pathological obstruction of the right vertebral artery (VA). RESULTS: Patient 1 exhibited the 3 major neurological symptoms of right crossed sensory disturbance, right cerebellar ataxia and bulbar palsy. (Wallenbergs Syndrome) causes the person to have balance problems and lean to one side. METHOD: This study was carried out on brain tissue from 2 patients with typical Wallenberg syndrome and 10 autopsy cases without central nervous system disturbances. Artery (PICA) carries blood to this part of the brain. It is caused most commonly due to atherothrombotic vertebral artery occlusion, followed by posterior inferior cerebellar artery (PICA) and medullary arteries. Key Points: Lateral medullary syndrome is most commonly due to occlusion of the intracranial portion of the vertebral artery followed by PICA and its branches. BACKGROUND: Wallenberg syndrome was first reported by Adolf Wallenberg as arising due to the obstruction of the posterior inferior cerebellar artery (PICA), which caused an infarct in the lateral medulla oblongata (MO). Wallenberg’s syndrome or lateral medullary syndrome is associated with a variety of symptoms due to involvement of lateral segment of the medulla.
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