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Right Vertebral Artery Dissection, Lateral Medullary Syndrome (Wallenberg Syndrome)

Shogan PJS - MedPix (2008)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Right Vertebral Artery Dissection, Lateral Medullary Syndrome (Wallenberg Syndrome)

History: 28 y.o. woman, four months postpartum, with onset of neck pain, severe vertigo associated with severe vomiting, anesthesia of the right hemi-facial region and loss of sensation in the region of the left upper and lower extremities immediately following cervical chiropractic manipulation. The patient was unsuccessfully treated for vertigo associated with Meniere’s disease. The patient underwent a second cervical chiropractic treatment 15 days later, and presented with recurrent severe vertigo and associated hemi-anesthesia and difficulty phonating. Imaging was obtained one month following the initial chiropractic treatment

Findings: Occlusion of the right vertebral artery at the C1-2 level with subacute infarction of the right lateral medulla oblongata, and chronic infarction of the left flocculonodular lobe, as a result of traumatic chiropractic cervical manipulation.

Ddx: Dissection Racemose Capillary Telangiectasia

Dxhow: MRI and Angiogram

No MeSH data available.


FLAIR axial images at the level of the medulla oblongata and flocculonodular lobe of the cerebellum reveal increased signal abnormality involving the right lateral aspect of the medulla oblongata, and a small rim of abnormal signal in the left flocculonodular lobe surrounding the wedge shaped defect.  Additionally, a tiny amount of increased signal is noted in the right paramedullary cistern, consistent with intramural hematoma in the right vertebral artery.
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MPX2563_synpic41803: FLAIR axial images at the level of the medulla oblongata and flocculonodular lobe of the cerebellum reveal increased signal abnormality involving the right lateral aspect of the medulla oblongata, and a small rim of abnormal signal in the left flocculonodular lobe surrounding the wedge shaped defect. Additionally, a tiny amount of increased signal is noted in the right paramedullary cistern, consistent with intramural hematoma in the right vertebral artery.


Right Vertebral Artery Dissection, Lateral Medullary Syndrome (Wallenberg Syndrome)

Shogan PJS - MedPix (2008)

FLAIR axial images at the level of the medulla oblongata and flocculonodular lobe of the cerebellum reveal increased signal abnormality involving the right lateral aspect of the medulla oblongata, and a small rim of abnormal signal in the left flocculonodular lobe surrounding the wedge shaped defect.  Additionally, a tiny amount of increased signal is noted in the right paramedullary cistern, consistent with intramural hematoma in the right vertebral artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2563&req=5

MPX2563_synpic41803: FLAIR axial images at the level of the medulla oblongata and flocculonodular lobe of the cerebellum reveal increased signal abnormality involving the right lateral aspect of the medulla oblongata, and a small rim of abnormal signal in the left flocculonodular lobe surrounding the wedge shaped defect. Additionally, a tiny amount of increased signal is noted in the right paramedullary cistern, consistent with intramural hematoma in the right vertebral artery.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Right Vertebral Artery Dissection, Lateral Medullary Syndrome (Wallenberg Syndrome)

History: 28 y.o. woman, four months postpartum, with onset of neck pain, severe vertigo associated with severe vomiting, anesthesia of the right hemi-facial region and loss of sensation in the region of the left upper and lower extremities immediately following cervical chiropractic manipulation. The patient was unsuccessfully treated for vertigo associated with Meniere’s disease. The patient underwent a second cervical chiropractic treatment 15 days later, and presented with recurrent severe vertigo and associated hemi-anesthesia and difficulty phonating. Imaging was obtained one month following the initial chiropractic treatment

Findings: Occlusion of the right vertebral artery at the C1-2 level with subacute infarction of the right lateral medulla oblongata, and chronic infarction of the left flocculonodular lobe, as a result of traumatic chiropractic cervical manipulation.

Ddx: Dissection Racemose Capillary Telangiectasia

Dxhow: MRI and Angiogram

No MeSH data available.