Presentation
Sudden onset of ataxia (the patient was falling towards the right side), dysarthria and dysphagia.
Patient Data












There is a diffusion restriction involving the right lateral aspect of medulla oblongata and a focus at the ipsilateral vermis on DWI and ADC sequences in keeping with ischaemic infarction.
Absent flow/occlusion of the intracranial portion of the right vertebral and PICA arteries are seen on T1 C+ and TOF MRA images.
Note is made of left occipital encephalomalacia and diffuse cerebral atrophy.
Case Discussion
Lateral medullary syndrome, also known as Wallenberg syndrome, is a clinical syndrome caused by an acute ischaemic infarct of the lateral medulla oblongata. This is most commonly due to occlusion of the intracranial portion of the vertebral artery followed by PICA and its branches.