A Case of Wallenberg Syndrome due to Vertebral Artery Dissection

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  • Suda Satoshi
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Okubo Seiji
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Abe Arata
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Kanamaru Takuya
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Saito Tomonari
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Kamiya Nobuo
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Sakamaki Masanori
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Mishina Masahiro
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Ueda Masayuki
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Katsura Ken-ichiro
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
  • Katayama Yasuo
    Department of Neurological, Nephrological and Rheumatological Science, Graduate School of Medicine, Nippon Medical School Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School

Bibliographic Information

Other Title
  • 椎骨動脈解離によるＷａｌｌｅｎｂｅｒｇ症候群
  • 症例から学ぶ 椎骨動脈解離によるWallenberg症候群
  • ショウレイ カラ マナブ ツイコツ ドウミャク カイリ ニ ヨル Wallenberg ショウコウグン

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Abstract

Vertigo and nausea suddenly developed in a 33-year-old man without a relevant medical history. He reported that he had had throbbing headaches for 1 month. On admission, neurological examination revealed dysarthria, right Horner syndrome, and hypoesthesia of the left side of the face and of the left side of the body below the neck. Initial magnetic resonance imaging of the brain showed no areas of abnormal intensity on diffusion-weighted imaging, but magnetic resonance angiography showed a stringlike structure of the right vertebral artery. Acute infarction due to right vertebral artery dissection was diagnosed. Heparin sodium was immediately administered intravenously. Three days after symptom onset, magnetic resonance imaging-diffusion-weighted imaging of the brain clearly showed a high-intensity area in the right lateral medulla oblongata, a finding that confirmed the clinical diagnosis. This case emphasizes that vertebral artery dissection should be considered in patients with vertigo, especially young patients without risk factors for cerebrovascular disorders. The clinical history and neurological examination remain fundamental aspects of patient assessment in the era of advanced neuroimaging.<br>

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