Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Case Report

Lateral Medullary Infarction with Contralateral Segmental Dysesthesia and Ipsilateral Headache: A Case Report

Author(s): Renjie Wang, Yankun Shao* and Lei Xu*

Volume 18, Issue 8, 2022

Published on: 07 February, 2022

Article ID: e171121198015 Pages: 5

DOI: 10.2174/1573405617666211117142203

Price: $65

Abstract

Introduction: The medulla oblongata is the lowest segment of the brain stem, located adjacent to the spinal cord, with a complex anatomical structure. Thus, a small injury to the medulla oblongata can show complex clinical manifestations.

Case Presentation: A patient experienced dysesthesia, which manifested as numbness in her right lower limb and decreased temperature sense, and dizziness 20 days before admission. The numbness worsened 1 week before admission, reaching the right Thoracic (T) 12 dermatomes. Her thermoception below the T12 dermatomes decreased, and the degree of dizziness increased, accompanied by nausea and vomiting. Magnetic Resonance Imaging (MRI) of the neck, chest, and abdomen performed at a local hospital showed no abnormalities. MRI of the brain was performed after admission. One week after admission, she experienced a severe headache in the upper left periorbital area. The numbness extended to T4, and thermoception decreased below T4.

Diagnosis: Lateral medullary infarction.

Interventions: Anti-platelet aggregation and mitochondrial nutritional therapies were performed along with treatments for improving circulation and establishing collateral circulation.

Outcomes: The intensity of limb numbness decreased, and the symptoms of headache and dizziness resolved.

Conclusion: Lesions leading to segmental sensory disorders can occur in the medulla oblongata. Ipsilateral headaches with contralateral segmental paresthesia can be a specific sign of lateral medullary infarction.

Keywords: Sensory disturbance, headache, medullary infarction, MRI, medulla oblongata, contralateral segmental dysesthesia.

[1]
Iwasaki Y, Nakamura T, Hamada K. Hypoalgesia and hypothermesthesia in a lower extremity due to compression of the medulla oblongata by an elongated vertebral artery. Rinsho Shinkeigaku 2004; 44(3): 176-81.
[PMID: 15233270]
[2]
Ruiz-Miyares F, Kuriakose R, Deleu D, Al-Hail H, Akhtar N, Mesraoua B. Crossed pattern of sensory loss with left thoracic level in a right dorsolateral medullary infarction. Rev Neurol 2008; 47(7): 361-2.
[PMID: 18841547]
[3]
Ikeda K, Kinoshita M, Iwasaki Y, Wakata N. Sensory disturbance of crossed oral-pedal topography in a case of lateral medullary infarction. No To Shinkei 1998; 50(10): 949-52.
[PMID: 9842555]
[4]
MacGowan DJ, Janal MN, Clark WC, et al. Central poststroke pain and Wallenberg’s lateral medullary infarction: Frequency, character, and determinants in 63 patients. Neurology 1997; 49(1): 120-5.
[http://dx.doi.org/10.1212/WNL.49.1.120] [PMID: 9222179]
[5]
Treister AK, Hatch MN, Cramer SC, Chang EY. Demystifying poststroke pain: from etiology to treatment. PM R 2017; 9(1): 63-75.
[http://dx.doi.org/10.1016/j.pmrj.2016.05.015] [PMID: 27317916]
[6]
Nakazato Y, Yoshimaru K, Ohkuma A, Araki N, Tamura N, Shimazu K. Central post-stroke pain in Wallenberg syndrome. No To Shinkei 2004; 56(5): 385-8.
[PMID: 15279195]
[7]
Fiore DC, Pasternak AV, Radwan RM. Pain in the quiet (not red) eye. Am Fam Physician 2010; 82(1): 69-73.
[PMID: 20590074]
[8]
Zhang SQ, Liu MY, Wan B, Zheng HM. Contralateral body half hypalgesia in a patient with lateral medullary infarction: A typical Wallenberg syndrome. Eur Neurol 2008; 59(3-4): 211-5.
[http://dx.doi.org/10.1159/000114050] [PMID: 18230887]

Rights & Permissions Print Cite
Article Metrics
16
1
© 2024 Bentham Science Publishers | Privacy Policy