Ulloa-Alday JO, Cantú-Ibarra SA, Melo-Sánchez MG, Berino-Pardo DN

Language: Spanish
References: 15
Page: 491-498
PDF size: 736.49 Kb.

ABSTRACT

Cerebrovascular disease is a clinical syndrome characterized by the rapid development of focal neurological signs that persist for more than 24 hours without apparent cause other than vascular origin. It’s classified in two subtypes: ischemia and hemorrhage. Cerebral ischemia is the result of occlusion of a vessel and can be temporary or permanent manifestations, which implies an irreversible neuronal damage. In recent years in developing countries has been an increase in the levels of mortality from cerebrovascular disease, in Mexico it was reported that the CVD occupied the sixth disease among the first causes of death in the country on 2010; according to the World Health Organization in the world is the second overall cause of death, of which 4.95 million occur in middle and low income. Wallenberg syndrome or lateral medullary infarction is the most common vascular syndrome on the posterior circulation, which triggers a compromise of the lateral portion of the bulb, where structures that are affected are the spinal trigeminal branch, the spinothalamic tract, the ambiguus nucleus of the vagus, the inferior cerebellar peduncle and descending sympathetic fibers, which manifests with signs of posterolateral medullary lesion easily recognizable. The lateral region of the bulb has a variable irrigation, mostly is supplied by branches of the intracranial vertebral artery (IVA), followed in frequency dual irrigation branches of AVIC and posterior inferior cerebellar artery (PICA) and in less proportion is given only by PICA. The typical neurological signs of this syndrome include: ipsilateral Horner’s syndrome, contralateral thermoalgic hypoalgesia on arm, trunk and leg, ipsilateral thermoalgic hypolgesia facial with corneal reflex decreased, ipsilateral limb ataxia, nystagmus, ipsilateral velopalatal paresis and facial paresis with less frequently. This paper reports the case of a male patient who presented moderate occipital headache, dizziness, nausea and vomiting, numbness of the right hemibody and the left side of the face, sudden gait instability, making clinical diagnosis of Wallenberg syndrome and confirmed by imaging.

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