KMID : 0858420110130030137
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Korean Journal of Stroke 2011 Volume.13 No. 3 p.137 ~ p.139
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A Case of Ipsilateral Hemiparesis in Lateral Medullary Infarction: As a Warning Sign of Acute Progression of Vertebral Artery Thrombosis
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Hur Tae-Hun
Lee Dong-Hyun Park Jeong-Ho
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Abstract
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A 70-year-old man presented with acute dysarthria and dizziness. He denied any history of trauma or cervical manipulations within several weeks before symptom onset. We could make a presumptive diagnosis of left Wallenberg syndrome through the results of neurologic examination, which include left limb ataxia, alternating hyp(o)esthesia, spontaneous nystagmus to right side, and left side Honer¡¯s syndrome. Initial diffusion weighted imaging performed at admission showed small and discrete high signal lesions in left lateral medulla, left cerebellar hemisphere, and bilateral occipital areas. Contrast enhanced MRA demonstrated a fi lling defect in long segment of distal left vertebral artery. On 4th days after symptom onset, the patient developed a severe form of ipsilateral hemiparesis. Follow-up brain MRI showed a downward extension of the initial ischemic lesion in upper medulla to upper cervical region. This case suggests that a severe form of ipsilateral hemiparesis may be complicated in the clinical setting of acute lateral medullary infarction with vertebral artery occlusion.
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KEYWORD
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Lateral medullary infarction, Ipsilateral hemiparesis, Vertebral artery occlusion
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