scholarly journals Wallenberg Syndrome with Associated Motor Weakness in a Two-Week-Postpartum Female

2015 ◽  
Vol 7 (3) ◽  
pp. 186-190 ◽  
Author(s):  
David W. Louis ◽  
Nimit Dholakia ◽  
Michael J. Raymond

A 30-year-old, right-handed female presented 2 weeks postpartum with acute-onset severe headache, vertigo, and vomiting. Initial neurologic examination illustrated lingual dysarthria, horizontal nystagmus, right dysmetria on finger-to-nose testing, and weakness of the extremities. Magnetic resonance imaging showed a large, left lateral medullary infarction (Wallenberg syndrome) with cephalad extension into the ipsilateral pons as well as involvement of the left middle cerebellar peduncle. The patient was discharged 3 weeks later to an inpatient rehabilitation facility with gradual improvement of her symptoms.

2021 ◽  
Vol 14 (1) ◽  
pp. e240270
Author(s):  
Mazhar Warraich ◽  
Paul Bolaji ◽  
Saugata Das

A 19-year-old man was admitted with a 2-week history of continuous cough along with a day history of acute onset unsteadiness and hiccups. Given the current pandemic, he was initially suspected to have COVID-19, however he tested negative on two occasions. Subsequent brain magnetic resonance imaging (MRI)confirmed a small left acute and subacute lateral medullary infarction with chest X-ray suggesting aspiration pneumonia with right lower lobe collapse. This is a distinctive case of posterior circulation stroke presenting with a new continuous cough in this era of COVID-19 pandemic. We anticipate based on MRI findings that his persistent cough was likely due to silent aspiration from dysphagia because of the subacute medullary infarction. It is therefore imperative that healthcare workers evaluate people who present with new continuous cough thoroughly to exclude any other sinister pathology. We should also be familiar with the possible presentations of posterior circulation stroke in this pandemic era.


2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Abinayaa Ravichandran ◽  
Kareem S. Elsayed ◽  
Hussam A. Yacoub

Background. Central pain mimicking trigeminal neuralgia (TN) as a result of lateral medullary infarction or Wallenberg syndrome has been rarely reported. Case Report. We discuss a patient who presented with a lateral medullary infarct and shortly after developed facial pain mimicking TN. We also elaborate on the anatomical pathway of the trigeminal nerve explaining facial pain as a result of a lateral medullary lesion. Discussion. Clinicians should be aware of this typical complication of lateral medullary infarct in order to attain proper management and work-up.


2018 ◽  
Vol 79 (S 05) ◽  
pp. S420-S421
Author(s):  
Hussam Abou-Al-Shaar ◽  
Gmaan Alzhrani ◽  
Yair Gozal ◽  
William Couldwell

The case described in this video involved a 38-year-old man, who presented with a 4-week history of worsening acute-onset headache, nausea, double vision, and vertigo. On examination, he had impaired tandem gait and diplopia on right horizontal gaze. A computed tomography (CT) scan revealed a hyperdense lesion of the right cerebellopontine angle. Magnetic resonance imaging (MRI) revealed a nonenhancing middle cerebellar peduncle lesion that was isointense on T2-weighed imaging and hypointense on FLAIR imaging (Fig. 1A–B). The differential diagnoses for this lesion included cavernous malformation, thrombosed aneurysm, and neurocysticercosis. CT angiography was done preoperatively to rule out cerebral aneurysm. Surgical resection of the lesion was recommended to relieve his symptoms, to prevent further deterioration/bleeding, and to obtain a pathological diagnosis. The patient underwent a right retrosigmoid craniotomy for resection of the right middle cerebellar peduncle cavernoma (Fig. 2). The patient tolerated the procedure well with no new postoperative neurological deficit. Postoperative MRI depicted gross total resection of the lesion and expected residual blood in the resection cavity (Fig. 1C–D). The patient was discharged home on postoperative day 4. At his last follow-up appointment, 1 month after surgery, he reported complete resolution of his preoperative symptoms, including diplopia. The patient gave consent for publication.The link to the video can be found at: https://youtu.be/TRieS9DXbV4.


2008 ◽  
Vol 59 (3-4) ◽  
pp. 211-215 ◽  
Author(s):  
She-Qing Zhang ◽  
Ming-Yuan Liu ◽  
Bo Wan ◽  
Hui-Min Zheng

2019 ◽  
Vol 28 (4) ◽  
pp. 1381-1387
Author(s):  
Ying Yuan ◽  
Jie Wang ◽  
Dongyu Wu ◽  
Dahua Zhang ◽  
Weiqun Song

Purpose Severe dysphagia with weak pharyngeal peristalsis after dorsal lateral medullary infarction (LMI) requires long-term tube feeding. However, no study is currently available on therapeutic effectiveness in severe dysphagia caused by nuclear damage of vagus nerve after dorsal LMI. The purpose of the present investigation was to explore the potential of transcutaneous vagus nerve stimulation (tVNS) to improve severe dysphagia with weak pharyngeal peristalsis after dorsal LMI. Method We assessed the efficacy of 6-week tVNS in a 28-year-old woman presented with persisting severe dysphagia after dorsal LMI who had been on nasogastric feeding for 6 months. tVNS was applied for 20 min twice a day, 5 days a week, for 6 weeks. The outcome measures included saliva spitted, Swallow Function Scoring System, Functional Oral Intake Scale, Clinical Assessment of Dysphagia With Wallenberg Syndrome, Yale Pharyngeal Residue Severity Rating Scale, and upper esophagus X-ray examination. Results After tVNS, the patient was advanced to a full oral diet without head rotation or spitting. No saliva residue was found in the valleculae and pyriform sinuses. Contrast medium freely passed through the upper esophageal sphincter. Conclusion Our findings suggest that tVNS might provide a useful means for recovery of severe dysphagia with weak pharyngeal peristalsis after dorsal LMI. Supplemental Material https://doi.org/10.23641/asha.9755438


Author(s):  
Forrest A. Hamrick ◽  
Michael Karsy ◽  
Carol S. Bruggers ◽  
Angelica R. Putnam ◽  
Gary L. Hedlund ◽  
...  

AbstractLesions of the cerebellopontine angle (CPA) in young children are rare, with the most common being arachnoid cysts and epidermoid inclusion cysts. The authors report a case of an encephalocele containing heterotopic cerebellar tissue arising from the right middle cerebellar peduncle and filling the right internal acoustic canal in a 2-year-old female patient. Her initial presentation included a focal left 6th nerve palsy. Magnetic resonance imaging was suggestive of a high-grade tumor of the right CPA. The lesion was removed via a retrosigmoid approach, and histopathologic analysis revealed heterotopic atrophic cerebellar tissue. This report is the first description of a heterotopic cerebellar encephalocele within the CPA and temporal skull base of a pediatric patient.


1970 ◽  
Vol 24 (1) ◽  
pp. 9-16
Author(s):  
Md Bahadur Ali Miah ◽  
Abdul Kader Sheikh ◽  
Akhlaque Hosain Khan ◽  
Md Rafiqul Islam ◽  
AKM Anwar Ullah ◽  
...  

This study was undertaken in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from January 2002 to December 2003. The objective of this study was to determine the initial neurologic symptoms of multiple sclerosis among Bangladeshi patients. A total of 25 respondents of multiple sclerosis patients as cases selected by McDonald et al. (2001) diagnostic criteria for multiple sclerosis were enlisted during the study period. The clinical details, investigations of the respondents were reviewed. Data were recorded in predesigned data collection sheet. Out of 25 cases, male patients were 12 (48%) and females were 13 (52%), ratio being 1:1.08. Majority of the patients presented at second, third and fourth decades of life. Most of the patients (56%) had acute onset, followed by subacute (28%) and insidious (16%). Certain clinical characteristics among Bangladeshi multiple sclerosis patients are noteworthy, namely, number of male and female patients almost equal (48% vs 52%), a higher rate of impaired vision (optic nerve involvement, 64%), motor weakness (92%), sphincteric disturbances (92%) and a lower rate of brainstem and cerebellar involvement. Painful tonic spasm was a prominent feature among Bangladeshi patients with multiple sclerosis (8 out of 25, 32%). Out of 25 patients, one (4%) expired due to aspiration pneumonia. Twenty four (96%) survived. Among them 9 (36%) has restricted activity, 7 (28%) were bedridden, 5 (20%) were chairbound, 2 (8%) had minor disability and were in work and 1 (4%) was completely normal. DOI: http://dx.doi.org/10.3329/bjn.v24i1.3035 Bangladesh Journal of Neuroscience 2008; Vol. 24 (1) :9-16


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