medigraphic.com
Órgano Oficial del Hospital Angeles Health System

2024, Number 2

<< Back Next >>

Acta Med 2024; 22 (2)

Wallenberg´s syndrome: neuroanatomical correlation

Ichazo CJP, Abdo TMA, Garfias RMA, García GB, Dorantes AA

Language: Spanish
References: 31
Page: 127-133
PDF size: 289.73 Kb.


ABSTRACT

The most common clinical presentation of posterior circulation cerebral vascular events is Wallenberg syndrome. Its clinical manifestation includes various signs and symptoms, most easily explained by anatomical correlation with the affected structures. Their study is a clear reflection of the importance of neuroanatomy in clinical application. First described in 1895 by Polish neurologist Adolf Wallenberg, Wallenberg syndrome is caused by infarction of the lateral and posterior portion of the inferior olive nucleus of the medulla oblongata right in the territory irrigated by the posteroinferior cerebellar artery (PICA). The most common described causes of Wallenberg syndrome are, in order of frequency, atherothrombotic occlusion of the vertebral artery, posteroinferior cerebelar artery or medullary arteries, cardioembolism and vertebral dissection. However, there are other, less common but well described causes of Wallenberg syndrome, such as the use of emerging drugs known as legal highs, cocaine use, sarcoidosis, granulomatosis with polyangiitis (Wegener's granulomatosis), giant cell arteritis, scorpion bite, and even unruptured PICA aneurysms. This article reviews the specific clinical characteristics of Wallenberg syndrome, and details of the neuro-anatomic basis of its classical presentation.


REFERENCES

  1. Zeidman LA, Mohan L. Adolf Wallenberg: giant in neurology and refugee from Nazi Europe. J Hist Neurosci. 2014; 23 (1): 31-44.

  2. Lui F, Bhimji SS. Wallenberg syndrome [Updated 2017 Dec 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018. Available in: https://www.ncbi.nlm.nih.gov/books/NBK470174/

  3. Shenavandeh S, Petramfar P. Three atypical manifestations of granulomatosis with polyangiitis: lateral medullary syndrome, anterior cheek mass and melting scleritis of eye. Reumatologia. 2017; 55 (3): 145-150.

  4. Wu S, Li N, Xia F, Sidlauskas K, Lin X, Qian Y et al. Neurotrophic keratopathy due to dorsolateral medullary infarction (Wallenberg syndrome): case report and literature review. BMC Neurol. 2014; 14: 231.

  5. Canepa Raggio C, Dasgupta A. Three cases of Spontaneous Vertebral Artery Dissection (SVAD), resulting in two cases of Wallenberg syndrome and one case of Foville syndrome in young, healthy men. BMJ Case Rep. 2014; 2014: bcr2014203945.

  6. Arora A, Kumar A, Raza MN. 'Legal high' associated Wallenberg syndrome. BMJ Case Rep. 2013; 2013: bcr2013009693.

  7. Mullaguri N, Battineni A, Narayan A, Guddeti R. Cocaine induced bilateral posterior inferior cerebellar artery and hippocampal infarction. Cureus. 2018; 10 (5): e2576.

  8. Oks M, Li A, Makaryus M, Pomeranz HD, Sachdeva M, Pullman J et al. Sarcoidosis presenting as Wallenberg syndrome and panuveitis. Respir Med Case Rep. 2018; 24: 16-18.

  9. Stengl KL, Buchert R, Bauknecht H, Sobesky J. A hidden giant: Wallenberg syndrome and aortal wall thickening as an atypical presentation of a giant cell arteritis. BMJ Case Rep. 2013; 2013: bcr2012006994.

  10. Thomas VV, George T, Mishra AK, Mannam P, Ramya I. Lateral medullary syndrome after a scorpion sting. J Family Med Prim Care. 2017; 6 (1): 155-157.

  11. Malik MT, Kenton Iii EJ, Vanino D, Dalal SS, Zand R. Lateral medullary ischemic infarct caused by posterior inferior cerebellar artery aneurysm. Case Rep Neurol. 2017; 9 (3): 316-319.

  12. Kiernan JA, Rajakumar N. Barr's the human nervous system: an anatomical viewpoint. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2014.

  13. Mtui E, Gruener G, Dockery P. Fitzgerald's clinical neuroanatomy and neuroscience. 7th ed. Philadelphia: Elsevier; 2016.

  14. Rajasekhar SSSN, Aravindhan K, Tamgire DW. Duplicated and hypoplastic V4 segment of vertebral artery along with duplication of anterior inferior cerebellar artery: a case report. J Clin Diagn Res. 2017; 11 (8): AD03-AD05.

  15. Pai BS, Varma RG, Kulkarni RN, Nirmala S, Manjunath LC, Rakshith S. Microsurgical anatomy of the posterior circulation. Neurol India. 2007; 55 (1): 31-41.

  16. Demartini ZJ, de Oliveira TVH, Guimaraes RMDR, Lohr A Jr, Koppe GL, Gatto LAM. Posterior inferior cerebellar artery origin over the C2 posterior arch. Pediatr Neurosurg. 2018; 53 (5): 364-366.

  17. Liu IW, Ho BL, Chen CF, Han K, Lin CJ, Sheng WY et al. Vertebral artery terminating in posterior inferior cerebellar artery: A normal variation with clinical significance. PLoS One. 2017; 12 (4): e0175264.

  18. Fine AD, Cardoso A, Rhoton AL Jr. Microsurgical anatomy of the extracranialextradural origin of the posterior inferior cerebellar artery. J Neurosurg. 1999; 91 (4): 645-652.

  19. Lister JR, Rhoton AL Jr, Matsushima T, Peace DA. Microsurgical anatomy of the posterior inferior cerebellar artery. Neurosurgery. 1982; 10 (2): 170-199.

  20. Rodríguez-Hernández A, Rhoton AL Jr, Lawton MT. Segmental anatomy of cerebellar arteries: a proposed nomenclature. Laboratory investigation. J Neurosurg. 2011; 115 (2): 387-397.

  21. Argente H, Álvarez ME. Semiología médica: fisiopatología, semiotecnia y propedéutica: enseñanza-aprendizaje centrada en la persona. 2ª ed. Buenos Aires: Médica Panamericana; 2013.

  22. Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS. Lateral medullary infarction with or without extra-lateral medullary lesions: what is the difference? Cerebrovasc Dis. 2018; 45 (3-4): 132-140.

  23. Cidad P, Boto A, Del Hierro A, Capote M, Noval S, Garcia A et al. Unilateral punctate keratitis secondary to Wallenberg syndrome. Korean J Ophthalmol. 2014; 28 (3): 278-283.

  24. Kim H, Lee HJ, Park JW. Clinical course and outcome in patients with severe dysphagia after lateral medullary syndrome. Ther Adv Neurol Disord. 2018; 11: 1756286418759864.

  25. El Mekkaoui A, Irhoudane H, Ibrahimi A, El Yousfi M. Dysphagia caused by a lateral medullary infarction syndrome (Wallenberg's syndrome). Pan Afr Med J. 2012; 12: 92.

  26. Jaimes A, García-Sáez R, Gutiérrez-Viedma A, Cuadrado ML. Case report: Wallenberg's syndrome, a possible cause of symptomatic epicrania fugax. Cephalalgia. 2018; 38 (6): 1203-1206.

  27. Ogawa T, Shojima Y, Kuroki T, Eguchi H, Hattori N, Miwa H. Cervico-shoulder dystonia following lateral medullary infarction: a case report and review of the literature. J Med Case Rep. 2018; 12 (1): 34.

  28. Sivakumar K, Garcha M, Mehta D, Leary MC, Yacoub HA. Central hypoventilation: a rare complication of wallenberg syndrome. Case Rep Neurol Med. 2018; 2018: 4894820.

  29. Das P, Chopra A, Rai A, Kuppuswamy PS. Late-onset recurrent mania as a manifestation of Wallenberg syndrome: a case report and review of the literature. Bipolar Disord. 2015; 17 (6): 677-682.

  30. Huynh TR, Decker B, Fries TJ, Tunguturi A. Lateral medullary infarction with cardiovascular autonomic dysfunction: an unusual presentation with review of the literature. Clin Auton Res. 2018; 28 (6): 569-576.

  31. Yeo SS, Jang SH, Kwon JW. Lateral medullary syndrome following injury of the vestibular pathway to the core vestibular cortex: Diffusion tensor imaging study. Neurosci Lett. 2018; 665: 147-151.




2020     |     www.medigraphic.com