Acute medullary pyramidal infarction

Case contributed by Dr Chris O'Donnell


Vasculopath. Sudden onsest of weakness and vertigo ? stroke

Patient Data

Age: 50 years
Gender: Male

Extensive periventricular T2 brightening is very abnormal in a patient of this age and is consistent with diffuse small vessel disease.  Focus of abnormal T2 brightening in the right medullary pyramid with restricted diffusion (+ve ADC) and an occluded right vertebral artery.

Case Discussion

This is part of the spectrum of medial medullary syndrome due to occlusion of the anterior spinal artery at the time of vertebral artery occlusion.  It is very rare and presents with the classic triad of contralateral hemiplegia sparing the face, disturbance of deep sensation and ipsilateral hypoglossal nerve palsy.

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Case information

rID: 30702
Published: 29th Aug 2014
Last edited: 21st Nov 2019
Inclusion in quiz mode: Included

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