Ahmed Ibrahim Abdiwahid, Bakir Ahmet, Osman Sidow Nor, Mohamed Ali Abdiladhif, Farah Osman Mohamed, Ahmed Abdulkadir, Sheikh Hassan Mohamed
Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.
Ann Med Surg (Lond). 2023 Feb 17;85(3):542-544. doi: 10.1097/MS9.0000000000000260. eCollection 2023 Mar.
Lateral medullary syndrome (LMS) is a less common form of a brainstem stroke. It is the result of occlusion of the posterior inferior cerebellar artery (PICA). It is caused by atherosclerosis, thrombosis, or emboli from another source.
A 60-year-old male patient presented to the emergency department with vertigo, vomiting, slurred speech, hiccups, and left-side weakness associated with paresthesia for 1 day. He had a past medical history of uncontrolled hypertension and a smoking habit. The neurological examination revealed ataxia, and left hemiparesis associated with paresthesia. A cranial nerve examination revealed slight right-sided ptosis, mouth deviation, and loss of sensory sensation on the right side of the face. Brain MRI showed right medullary infarct consistent with LMS. Electrocardiogram, echocardiography, and vertebral artery color Doppler were normal. He was admitted to the neurology ward and was treated with low molecular weight heparin 60 mg subcutaneously, aspirin 300 mg, neuroprotective agents, and antihypertensive treatment. After 6 days of medical treatment, his condition has improved massively (dysarthria and dysphagia disappeared). He was discharged for physical rehabilitation.
LMS (Wallenberg syndrome) is one of the brainstem stroke syndromes caused by occlusion of PICA. Vertigo, vomiting, dysphagia, dysarthria, ipsilateral ataxia, Horner's syndrome, and contralateral hemiparesis define this syndrome. Brain MRI is necessary for diagnosis alongside clinical syndrome.
LMS is a rare form of brainstem stroke and carries a favorable prognosis if early hospitalization and treatment is applied. Brain MRI, including diffusion sequence, is the most useful diagnostic tool for detecting LMS.
外侧延髓综合征（LMS）是一种不太常见的脑干卒中形式。它是小脑后下动脉（PICA）闭塞的结果。其病因是动脉粥样硬化、血栓形成或来自其他部位的栓子。
一名60岁男性患者因眩晕、呕吐、言语含糊、呃逆及左侧无力伴感觉异常1天就诊于急诊科。他有高血压控制不佳的既往病史且有吸烟习惯。神经系统检查发现共济失调，左侧偏瘫伴感觉异常。脑神经检查发现右侧轻度上睑下垂、口角歪斜及右侧面部感觉丧失。脑部MRI显示符合LMS的右侧延髓梗死。心电图、超声心动图及椎动脉彩色多普勒检查均正常。他被收入神经内科病房，接受皮下注射低分子肝素60mg、阿司匹林300mg、神经保护剂及降压治疗。经过6天的药物治疗，他的病情有了显著改善（构音障碍和吞咽困难消失）。他出院进行身体康复治疗。
LMS（延髓背外侧综合征）是由PICA闭塞引起的脑干卒中综合征之一。眩晕、呕吐、吞咽困难、构音障碍、同侧共济失调、霍纳综合征及对侧偏瘫是该综合征的特征。除临床综合征外，脑部MRI对诊断是必要的。
LMS是一种罕见的脑干卒中形式，如果早期住院治疗，预后良好。包括弥散序列在内的脑部MRI是检测LMS最有用的诊断工具。
