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A 85 year old woman presented with vertigo, nausea and vomiting. Examination showed a left sided Horner's, left facial numbness; numbness over the right body; left sided ataxia, slurred speech, and weakness of the left soft palate.
Axial Flair MRI of the lower medulla: Note the high signal in the lateral medulla and inferior cerebellum on the left. This is in the distribution of the posterior inferior cerebellar artery (PICA). Infarctions of this artery result in Wallenberg's syndrome.
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