Irie Fumi, Toyoda Kazunori, Hagiwara Noriko, Fujimoto Shigeru, Okada Yasushi
Department of Cerebrovascular Disease and Clinical Research Institute, National Kyushu Medical Center, Fukuoka.
Intern Med. 2003 Sep;42(9):871-4. doi: 10.2169/internalmedicine.42.871.
Hemimedullary infarction, which presents Babinski-Nageotte syndrome, has been mainly reported to result from atherosclerotic occlusion of the vertebral artery. A 54-year-old housewife with right nuchal pain developed Wallenberg's syndrome followed by left hemiparesis. Diffusion-weighted magnetic resonance imaging documented fresh infarcts in the right hemimedulla and right dorsal cerebellum. Angiography revealed dissection of the right vertebral artery as a cause of the infarcts. Anterograde progression of the dissection might cause stepwise evolution of her neurological symptoms.