title: Medullary ischemia due to vertebral arteritis associated with Behçet syndrome: a case report.
abstract: Here we report an extremely rare case of Behçet syndrome (BS) that showed acute onset of Wallenberg syndrome and was treated successfully by corticosteroids. A 51-year-old woman with BS had a sudden onset of Wallenberg syndrome. Three days after the onset, she was transferred to our institute. In the magnetic resonance imaging (MRI) study on admission, T2-weighted and fluid-attenuated inversion recovery images showed a high intensity area in the left paramedian region of the medulla oblongata. Contrast-enhanced T1-weighted images showed enhancement in the vessel wall of the left vertebral artery. We diagnosed her as having Wallenberg syndrome due to the acute vertebral arteritis associated with BS. After initiation of high-dose steroid therapy, her symptoms gradually improved. Two months after admission, she was discharged from our institute with mild hemihypesthesia. We hypothesized that vertebral arteritis due to BS had caused hypoperfusion of the medullary perforators causing Wallenberg syndrome in our patient.
authors.affiliation: Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. kaido@ncnp.go.jp
authors.forename: Takanobu
authors.initials: T
authors.lastname: Kaido
authors.forename: Taisuke
authors.initials: T
authors.lastname: Otsuki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ogawa
authors.forename: Akio
authors.initials: A
authors.lastname: Takahashi
authors.forename: Yuu
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakata
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001167:Arteritis / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D001528:Behcet Syndrome / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D014854:Lateral Medullary Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008526:Medulla Oblongata / Q000098:blood supply*; D008875:Middle Aged; D014711:Vertebral Artery / Q000187:drug effects / Q000473:pathology*
chemical_list: D000305:Adrenal Cortex Hormones