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Kaplan Qbank USMLE



Author4 Posts
  #1

pt w/ rt sideed clumsiness,facial numbness and horner $,
lt sided body numbness& hoarseness and vertigo ,the most likely stroke
in the territory of which vessel?

  #2

If I am not mistaken, it's Wallenberg syndrome - lateral medullary syndrome - Posterior Inferior Cerebellar Artery. Strictly speaking, pt should have pain-temperature loss on ipsi face and contra body. If you did mean numbness and no pain temperature-loss, then I am probably wrong.

  #3

I have that..oclussion rhs vertebral followed by occlusion rhs PICA 2002. lhs arm in particular gets icy cold at times, although warm to the touch. Other times just lhs hand and maybe lhs neck and hand. Gate theory works fairly well, where rubbing of lhs arm nerves help relieve pain for a bit.

Seems to follow that Horners Syndrome and wallembergs syndrome gets worse the more I am fatigued or a few days after any strenuous body work. Question is though, why cold lhs and not warm when I get fatigued?

Anything which is nerve related takes time to come back if it does Im told.
Has anyone heard of this recovering and how long?
David@ahutchison.freeserve.co.uk

  #4

This "lateral medullary infarct" usually involves either the vertebral artery or PICA. The vestibular nucleus and or the spinal tract and nucleus of trigeminal and or the nucleus ambiguus may possibly be involved,depends on the extent of damage.

Sx- 1)vertigo 2)**ipsilateral cerebellar ataxia in the limbs

3)ipsilateral loss of pain & temperature on the face

4)complete Horner's . 5)hoarseness sometimes dysphagia

5) The ONLY contalateral sign isloss of pain and temp. in the trunk
and limbs

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