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Images in Neurology | October 2004

Lateral Lower Medullary Infarction

O. Igarashi, MD; N. Ogura, MD; T. Kiyozuka, MD; K. Kawabe, MD; H. Iguchi, MD; M. Maruyama, MD; T. Fujioka, MD; Y. Ichikawa, MD; K. Ikeda, MD; Y. Iwasaki, MD

Arch Neurol. 2004;61(10):1609. doi:10.1001/archneur.61.10.1609.

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A 41-year-old man without cardiovascular risk factors was admitted to our department because of a sudden onset of headache, vertigo, and dysesthesia of the left limbs. He was alert, and there were no vascular bruits.

At a neurological examination, ocular movements were normal with horizontal nystagmus bilaterally. His right pupil was miotic, but light reflexes were prompt. There was a slight hemiparesis on the right side. Deep tendon reflexes were slightly hyperactive bilaterally. Plantar responses were equivocal. Slight ataxia was seen on the right side. Decreased pinprick sensation was noted in the right side of the face and left limbs.

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These T2-weighted images show hyperintense signals in the lateral lower medulla involving pyramidal decussation (arrows). A, Frontal view. B, Lateral view.

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Igarashi OO, Ogura NN, Kiyozuka TT, et al. Lateral Lower Medullary Infarction. Arch Neurol. 2004;61(10):1609. doi:10.1001/archneur.61.10.1609.

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