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Lateral Medullary Infarction

A 52 year old man presented with vertigo, nausea and vomiting.  His neurologic exam also demonstrated right facial numbness, numbness over the left body, dysarthria, right sided ataxia and difficulty elevating the soft palate on the right.

Outline the Infarction

Axial MRI Flair Image: Note the small area of infarction in the right lateral medulla. Strokes of the lateral medulla usually results from vertebral artery or posterior inferior cerebellar artery strokes.  A unique clinical syndrome (Wallenberg's syndrome) follows, manifest by ipsilateral facial numbness, weakness of the soft palate, and ataxia, along with contralateral numbness of the body and limbs a well as vertigo, nausea and vomiting.

Revised 04/23/06.
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