Along with gait imbalance, it becomes nearly impossible for the patient to walk despite good muscle strength. Objects appear double, tilted, or swaying. Patients feel "seasick" or "off-balance" with nausea and vomiting. The facial pain can be quite bizarre with sharp jabs or jolts around the eye, ear, and forehead. Dizziness, vertigo, facial pain, double vision, and difficulty walking are the most common initial symptoms. During the first 48 hours after the stroke, the neurological deficit progresses and fluctuates. The area of the stroke is only about 0.39 in (1 cm) vertically in the lateral part of the medulla and does not cross the midline.įully 50% of patients report transient neurological symptoms for several weeks preceding the stroke. In younger patients, the vertebral artery dissection causes the infarct. In eight out of 10 cases, it is the vertebral artery that is occluded due to plaque buildup or because of a clot traveling from the heart. Initially, the PICA was thought to be the blocked major artery, but this has been disproved from autopsy studies. The blood supply to these areas is via a pair of vertebral arteries and its branch, called the posterior inferior cerebellar artery (PICA). The cerebellum is important for coordination. The medulla controls such important functions as swallowing, speech articulation, taste, breathing, strength, and sensation. The stroke occurs in the medulla and cerebellum. In a large stroke registry in Sweden gathered by Norving and Cronquist in 1991, only about 2% of all strokes over a six-year period were caused by LMI. Wallenberg syndrome is rare, and accurate estimates about incidence are unavailable. ![]() Wallenberg syndrome can also occur in younger people, but the underlying causes are different. They tend to have vascular risk factors such as hypertension, high cholesterol, and diabetes. It usually affects people over 40 years of age. The syndrome is also known as lateral medullary infarct (LMI) or posterior inferior cerebellar artery syndrome (PICA). But it wasn't until 1895 that Adolf Wallenberg eloquently described the different symptoms and signs and confirmed the findings during autopsy. The first clinical description was given by Gaspard Viesseux in 1808 and published by Alexander John Gaspard Marcet in 1811. It is caused by blockage in one of the arteries supplying the medulla and cerebellum. ![]() Wallenberg syndrome is a type of brain stem stroke manifested by imbalance, vertigo, difficulty swallowing, hoarseness of voice, and sensory disturbance.
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