Wallenberg syndrome

It is one of the most complex neurovascular syndromes and serves to repeat the basic neuroanatomical structure of the brainstem. A current patient with embolic vertebral artery occlusion helps us to demonstrate the unique features. I won’t go into the details here, but mention a few things:

  • If it is just the brainstem there may or may not be cerebellar signs (depending on how much the spinocerebellar tract is involved)
  • If it is big enough (as in our patient) and reaches to the front, there may be some pyramidal tract signs.
  • There is often (always, really) some facial neuropathic pain or itch
  • It may lead to sneezing or singultus, 2 neurological fascinating signs that are quite hard to treat.

References: any neuro textbook. Also remember the 4m4s-rule of brainstem anatomy.

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