Wallenberg Syndrome
Patients with posterior circulation strokes are misdiagnosed more than twice as often as those with anterior circulation strokes - Ava E. Pierce MD
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Wallenberg syndrome
Wallenberg syndrome was first described by Adolf Wallenberg in 1895 based on the clinical presentation of a live case of lateral medulla oblongata (MO) infarct. He performed a pathological analysis on the same patient’s autopsy in 1901, reporting the detailed pathology for the same. After 1901, this disease was called Wallenberg syndrome. However, it is most commonly caused due to occlusion of the vertebral artery followed by PICA.
Wallenberg syndrome is the most prevalent posterior ischemic stroke syndrome. 20% of the ischemic strokes occur in the posterior circulation. The most common causes of posterior circulation arterial disease are atherosclerosis, embolism, and dissection.
Lateral…
Resources
Posterior Circulation Strokes: Why do we miss them, and how do we improve?
Dizziness and vertigo account for approximately 4.4 million emergency department (ED) visits per year (approximately 4% of ED visits) Emergency medicine physicians must distinguish the self-limiting causes of dizziness from the serious causes. Strokes are the final diagnosis for 3–5% of these ED visits for dizziness and vertigo.
Neurological Impact of Wallenberg Syndrome on the Visual-Vestibular Systems
Wallenberg syndrome, also known as lateral medullary syndrome, is one of the most recognized brain-stem strokes.1 It was first described by Adolf Wallenberg in 1895 by clinical observations of the symptoms on a living patient and was later confirmed by pathology via autopsy.
Wallenberg syndrome
Clinical presentation can be attributed to the following: Vestibulo-cerebellar symptoms: vertigo, diplopia, and multidirectional nystagmus Autonomic dysfunction: Ipsilateral Horner’s syndrome. Hoarseness, dysphonia, dysphagia, and dysarthria.
EyeWiki
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). WS is typically due to ischemia from a posterior inferior cerebellar artery infarction. This monograph highlights the neuro-ophthalmic presentations for the WS.
GARD
Signs and symptoms may include swallowing difficulties, dizziness, hoarseness, nausea and vomiting, nystagmus, and problems with balance. Some people have uncontrollable hiccups, loss of pain and temperature sensation on one side of the face, and/or weakness or numbness on one side of the body. Wallenberg syndrome is often caused by a stroke in the brain stem.
National Institute of Neurological Disorders and Stroke
Wallenberg’s syndrome is a neurological condition caused by a stroke in the vertebral or posterior inferior cerebellar artery of the brain stem. Symptoms include difficulties with swallowing, hoarseness, dizziness, nausea and vomiting, rapid involuntary movements of the eyes (nystagmus), and problems with balance and gait coordination. Some individuals will experience a lack of pain and temperature sensation on only one side of the face, or a pattern of symptoms on opposite sides of the body – such as paralysis or numbness in the right side of the face, with weak or numb limbs on the left side. Uncontrollable hiccups may also occur
Physiopedia
The left and right vertebral arteries (VA) run along the ventrolateral aspect of the brainstem, supplying the medulla. Prior to joining together at the midline to form the basilar artery, both the left and right VA branch off to form, respectively, left and right posterior inferior cerebellar arteries (PICA), which themselves run dorsally and cross over to supply the lateral medulla on their way to the cerebellum. Structures that make up the lateral medulla include the inferior cerebellar peduncle, vestibular nuclei, trigeminal nucleus and tract, spinothalamic tract, descending sympathetic fibres, nucleus ambiguous and nucleus solitarius.
StatPearls
Wallenberg syndrome is also known as lateral medullary syndrome and posterior inferior cerebellar artery syndrome. This neurological disorder is associated with a variety of symptoms that occur as a result of damage to the lateral segment of the medulla posterior to the inferior olivary nucleus. It is the most common posterior circulation ischemic stroke syndrome.
StuDocu
Symptoms include difficulty with swallowing and hoarseness due to involvement of vagus and accessory nerve nuclei problems with balance and gait coordination due to involvement of the spinocerebellar tracts. Loss of pain and temperature sensationof the opposite side of the body due to involvement of the spinal lemniscus.
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