Title:Lateral Medullary Infarction with Contralateral Segmental Dysesthesia
and Ipsilateral Headache: A Case Report
Volume: 18
Author(s): Renjie Wang, Yankun Shao*Lei Xu*
Affiliation:
- Department
of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
- Department
of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
Keywords:
Sensory disturbance, headache, medullary infarction, MRI, medulla oblongata, contralateral segmental dysesthesia.
Abstract:
Introduction: The medulla oblongata is the lowest segment of the brain stem, located adjacent
to the spinal cord, with a complex anatomical structure. Thus, a small injury to the medulla
oblongata can show complex clinical manifestations.
Case Presentation: A patient experienced dysesthesia, which manifested as numbness in her right
lower limb and decreased temperature sense, and dizziness 20 days before admission. The numbness
worsened 1 week before admission, reaching the right Thoracic (T) 12 dermatomes. Her thermoception
below the T12 dermatomes decreased, and the degree of dizziness increased, accompanied
by nausea and vomiting. Magnetic Resonance Imaging (MRI) of the neck, chest, and abdomen
performed at a local hospital showed no abnormalities. MRI of the brain was performed after
admission. One week after admission, she experienced a severe headache in the upper left periorbital
area. The numbness extended to T4, and thermoception decreased below T4.
Diagnosis: Lateral medullary infarction.
Interventions: Anti-platelet aggregation and mitochondrial nutritional therapies were performed
along with treatments for improving circulation and establishing collateral circulation.
Outcomes: The intensity of limb numbness decreased, and the symptoms of headache and dizziness
resolved.
Conclusion: Lesions leading to segmental sensory disorders can occur in the medulla oblongata. Ipsilateral
headaches with contralateral segmental paresthesia can be a specific sign of lateral medullary
infarction.
