Posterior Inferior Cerebellar Artery Thrombosis (Wallenburg Syndrome)

Posterior Inferior Cerebellar Artery Thrombosis (Lateral medullary syndrome of Wallenburg)

Wallenburg syndrome: is associated with an infarction of a wedge shaped area of the lateral aspect of the medulla and the inferior surface of the cerebellum usually attributed to obstruction of blood flow in the posterior inferior cerebellar artery or one vertebral artery (Brain 1962).

The onset is often with severe vertigo, often with vomiting resembling acute paroxsymal vertigo of aural origin. Later symptoms of ipsilateral paralysis of the palatal, pharyngeal and laryngeal muscles due to involvement of.the nucleus ambiguous causes dysphasia and dysarthria. Involvement of the spinal tract nucleus and spinothalamic tract of the trigeminal nerve, gives anesthesia and paresthesias of the ipsilateral face and contra lateral trunk and limbs. Horner’s syndrome is also present on the affected side.

Disturbance of caloric response is noted in most cases.

If the lesion is restricted to the zone below the level of entry of the VIIIth Cranial nerves, the chief otoneurological abnormality is a directional preponderance to the opposite side. Deafness is absent.

If the lesion is situated within or extending into the zone above the entry of the VIIIth Cranial nerves, canal paresis, with or without deafness, appears to be the rule.