Lateral medullary syndrome


  • A 69 years old female
  • Background history of hypertension, right CVA with left hemiparesis.
  • Newly diagnosed AF
  • Complaining of headache with dizziness and diplopia for 1 day
  • Noted clinically worsening of nystagmus with left sided cerebellar sign

Imaging finding:

  • Plain CT brain do not demonstrate any abnormality except of old infarction at right corona radiata
  • MRI show abnormal signal at left side of medulla (yellow arrows) which is hypointense on T1, hyperintense on T2 and restricted diffusion on DWI/ADC images

Diagnosis: Acute infarction at left lateral medulla


  • Lateral medullary syndrome also known as Wallenberg syndrome
  • A clinical syndrome caused by acute ischaemic infarction of the lateral medulla oblongata
  • Hypertension is the commonest risk factor followed by smoking and diabetes mellitus
  • Constellation of neurologic symptoms due to injury to the lateral part of the medulla in the brain
  • Clinical symptoms include difficulty swallowing, slurred speech, facial pain, vertigo, Horner syndrome, and possibly palatal myoclonus
  • Sensory deficits affecting the trunk (torso) and extremities on the opposite side of the infarction
  • Sensory deficits affecting the face and cranial nerves on the same side with the infarct.
Author: radhianahassan