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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.


T1 weighted axial images at the level of the medulla oblongata and flocculonodular lobe reveal increased signal within the right vertebral artery (absent flow void), consistent with intramural hematoma.  The left vertebral artery reveals a normal signal related flow void.  A wedge shaped focus of decreased signal is noted within the left flocculonodular lobe.
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MPX2563_synpic41809: T1 weighted axial images at the level of the medulla oblongata and flocculonodular lobe reveal increased signal within the right vertebral artery (absent flow void), consistent with intramural hematoma. The left vertebral artery reveals a normal signal related flow void. A wedge shaped focus of decreased signal is noted within the left flocculonodular lobe.


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

Shogan PJS - MedPix (2008)

T1 weighted axial images at the level of the medulla oblongata and flocculonodular lobe reveal increased signal within the right vertebral artery (absent flow void), consistent with intramural hematoma.  The left vertebral artery reveals a normal signal related flow void.  A wedge shaped focus of decreased signal is noted within the left flocculonodular lobe.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

MPX2563_synpic41809: T1 weighted axial images at the level of the medulla oblongata and flocculonodular lobe reveal increased signal within the right vertebral artery (absent flow void), consistent with intramural hematoma. The left vertebral artery reveals a normal signal related flow void. A wedge shaped focus of decreased signal is noted within the left flocculonodular lobe.

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.