Wallenberg syndrome is a special type of medulla oblongata infarction with many and severe clinical dysfunction,which is dorsolateral medullary syndrome.Wallenberg syndrome can have various initial symptoms due to dif...Wallenberg syndrome is a special type of medulla oblongata infarction with many and severe clinical dysfunction,which is dorsolateral medullary syndrome.Wallenberg syndrome can have various initial symptoms due to different damaged parts.Typical clinical manifestations of the syndrome include dizziness,vomiting,dysphagia,cross sensory disturbance,ataxia,etc.Based on the complexity of functional anatomy,infarction in the medulla oblongata can produce various types of clinical symptoms or signs depending on the location.We describe the clinical comprehensive management of a 71-year-old man who presented with typical Wallenberg syndrome.Through early diagnosis and comprehensive clinical management,the prognosis of patient can be effectively improved.展开更多
Introduction: Autonomic nuclei affection results in variations in hemodynamics, temperature, sweating and ECG. Medullary strokes are challenging in their presentation, bizarre clinical signs, work and neurological out...Introduction: Autonomic nuclei affection results in variations in hemodynamics, temperature, sweating and ECG. Medullary strokes are challenging in their presentation, bizarre clinical signs, work and neurological outcome. The commonest cause is infarction of the posterior inferior cerebellar artery (PICA). Anatomical areas affected include the inferior cerebellar peduncle, dorsolateral medulla, nuclei of the Trigeminal, vestibular nuclei, Ninth and Vagus nerves. The descending sympathetic tracts and spin thalamic tracts. Serious cardiopulmonary events can complicate 11% of cases. Case Presentation: A middle-aged female developed sub-acute dizziness associated with vomiting and right head pains. She was unable to walk but remained cognitively clear. Her gastrointestinal symptoms were disabling and this was the main factor for presenting to the emergency room. The risk factors included hypertension and diabetes mellitus. Imaging studies were essential for posterior circulation stroke diagnosis and follow-up. She manifested remarkable autonomic features regarding the skin and hemodynamics. Nevertheless, the hospital course was controllable. Discussion: This case report was consistent with relevant literature in the contra lateral vaso motor changes and drop in body temperature during the acute phase. Moreover, our patient developed clinical and radiological extension through double antiplatelets. Superiority of the magnetic resonance imaging (MRI) scans in this patient enabled better diagnostic accuracy in a brainstem stroke. Conclusion: The autonomic features, in this case, represent major symptomatology and clinical signs. The variation in the hemodynamics and persistence of symptoms is thought provoking. This increases the awareness of emergency doctors for acute stroke presenting with autonomic features will enable early detection and helps outcome.展开更多
基金This study was supported by a grant from the Gansu Provincial Hospital in China(No.18GSSY4-31).
文摘Wallenberg syndrome is a special type of medulla oblongata infarction with many and severe clinical dysfunction,which is dorsolateral medullary syndrome.Wallenberg syndrome can have various initial symptoms due to different damaged parts.Typical clinical manifestations of the syndrome include dizziness,vomiting,dysphagia,cross sensory disturbance,ataxia,etc.Based on the complexity of functional anatomy,infarction in the medulla oblongata can produce various types of clinical symptoms or signs depending on the location.We describe the clinical comprehensive management of a 71-year-old man who presented with typical Wallenberg syndrome.Through early diagnosis and comprehensive clinical management,the prognosis of patient can be effectively improved.
文摘Introduction: Autonomic nuclei affection results in variations in hemodynamics, temperature, sweating and ECG. Medullary strokes are challenging in their presentation, bizarre clinical signs, work and neurological outcome. The commonest cause is infarction of the posterior inferior cerebellar artery (PICA). Anatomical areas affected include the inferior cerebellar peduncle, dorsolateral medulla, nuclei of the Trigeminal, vestibular nuclei, Ninth and Vagus nerves. The descending sympathetic tracts and spin thalamic tracts. Serious cardiopulmonary events can complicate 11% of cases. Case Presentation: A middle-aged female developed sub-acute dizziness associated with vomiting and right head pains. She was unable to walk but remained cognitively clear. Her gastrointestinal symptoms were disabling and this was the main factor for presenting to the emergency room. The risk factors included hypertension and diabetes mellitus. Imaging studies were essential for posterior circulation stroke diagnosis and follow-up. She manifested remarkable autonomic features regarding the skin and hemodynamics. Nevertheless, the hospital course was controllable. Discussion: This case report was consistent with relevant literature in the contra lateral vaso motor changes and drop in body temperature during the acute phase. Moreover, our patient developed clinical and radiological extension through double antiplatelets. Superiority of the magnetic resonance imaging (MRI) scans in this patient enabled better diagnostic accuracy in a brainstem stroke. Conclusion: The autonomic features, in this case, represent major symptomatology and clinical signs. The variation in the hemodynamics and persistence of symptoms is thought provoking. This increases the awareness of emergency doctors for acute stroke presenting with autonomic features will enable early detection and helps outcome.
