[Lateral medullary infarction presenting with truncal lateropulsion and decreased pain and temperature sensation below T10 sensory level]

Takahito Nishihira; Keisuke Suzuki; Hidehiro Takekawa; Toshiki Nakamura; Akio Iwasaki; Koichi Hirata

doi:10.5692/clinicalneurol.54.819

[Lateral medullary infarction presenting with truncal lateropulsion and decreased pain and temperature sensation below T10 sensory level]

Rinsho Shinkeigaku. 2014;54(10):819-23. doi: 10.5692/clinicalneurol.54.819.

[Article in Japanese]

Authors

Takahito Nishihira¹, Keisuke Suzuki, Hidehiro Takekawa, Toshiki Nakamura, Akio Iwasaki, Koichi Hirata

Affiliation

¹ Department of Neurology, Dokkyo Medical University.

PMID: 25342017
DOI: 10.5692/clinicalneurol.54.819

Abstract

A 45-year-old man noted a tendency to fall to the left side on standing following headache and vomiting. Neurological findings were unremarkable except for truncal lateropulsion to the left side. Brain magnetic resonance imaging (MRI) showed a small infarct in the left inferolateral part of medulla. Clinical and imaging findings suggested vertebral artery dissection as the cause of stroke. On hospital day 6, the patient developed decreased pain and temperature sensation in the right side below T10 sensory level and decreased sweating on the left side of the face with miosis of the left pupil. Brain MRI revealed an expanded lesion of the left inferolateral part of medulla. In our patient, the involvement of the spinocerebellar tract and the lateral spinothalamic tract likely contributed to the development of truncal lateropulsion and sensory disturbance below thoracic levels, respectively. Our case is clinically important in understanding a correlation between clinical symptoms and lateral medullary lesions.

Publication types

Case Reports

MeSH terms

Antipyrine / administration & dosage
Antipyrine / analogs & derivatives
Arginine / analogs & derivatives
Cerebral Infarction / diagnosis*
Cerebral Infarction / drug therapy
Cerebral Infarction / etiology*
Cerebral Infarction / pathology
Clopidogrel
Drug Therapy, Combination
Edaravone
Free Radical Scavengers / administration & dosage
Humans
Lateral Medullary Syndrome / etiology*
Magnetic Resonance Imaging
Male
Medulla Oblongata*
Middle Aged
Pipecolic Acids / administration & dosage
Platelet Aggregation Inhibitors / administration & dosage
Somatosensory Disorders / etiology*
Sulfonamides
Ticlopidine / administration & dosage
Ticlopidine / analogs & derivatives
Treatment Outcome
Vertebral Artery Dissection / complications
Vertebral Artery Dissection / diagnosis
Vertebral Artery Dissection / drug therapy
Vertebral Artery Dissection / pathology

Substances

Free Radical Scavengers
Pipecolic Acids
Platelet Aggregation Inhibitors
Sulfonamides
Arginine
Clopidogrel
argatroban
Ticlopidine
Edaravone
Antipyrine