title: [Lateral medullary infarction presenting with truncal lateropulsion and decreased pain and temperature sensation below T10 sensory level].
abstract: A 45-year-old man noted a tendency to fall to the left side on standing following headache and vomiting. Neurological findings were unremarkable except for truncal lateropulsion to the left side. Brain magnetic resonance imaging (MRI) showed a small infarct in the left inferolateral part of medulla. Clinical and imaging findings suggested vertebral artery dissection as the cause of stroke. On hospital day 6, the patient developed decreased pain and temperature sensation in the right side below T10 sensory level and decreased sweating on the left side of the face with miosis of the left pupil. Brain MRI revealed an expanded lesion of the left inferolateral part of medulla. In our patient, the involvement of the spinocerebellar tract and the lateral spinothalamic tract likely contributed to the development of truncal lateropulsion and sensory disturbance below thoracic levels, respectively. Our case is clinically important in understanding a correlation between clinical symptoms and lateral medullary lesions.
authors.affiliation: Department of Neurology, Dokkyo Medical University.
authors.forename: Takahito
authors.initials: T
authors.lastname: Nishihira
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Takekawa
authors.forename: Toshiki
authors.initials: T
authors.lastname: Nakamura
authors.forename: Akio
authors.initials: A
authors.lastname: Iwasaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000983:Antipyrine / Q000008:administration & dosage / Q000031:analogs & derivatives; D001120:Arginine / Q000031:analogs & derivatives; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D000077553:Edaravone; D016166:Free Radical Scavengers / Q000008:administration & dosage; D006801:Humans; D014854:Lateral Medullary Syndrome / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata; D008875:Middle Aged; D010875:Pipecolic Acids / Q000008:administration & dosage; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D020886:Somatosensory Disorders / Q000209:etiology*; D013449:Sulfonamides; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome; D020217:Vertebral Artery Dissection / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology
chemical_list: D016166:Free Radical Scavengers; D010875:Pipecolic Acids; D010975:Platelet Aggregation Inhibitors; D013449:Sulfonamides; D001120:Arginine; D000077144:Clopidogrel; C031942:argatroban; D013988:Ticlopidine; D000077553:Edaravone; D000983:Antipyrine