Lateral Medullary Syndrome — SCE Neurology MCQ

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EasyCerebrovascular DiseaseLateral Medullary SyndromeSCE Neurology

A 48-year-old woman with no vascular risk factors presents with acute onset vertigo, diplopia, dysarthria, left facial numbness and right-sided limb ataxia. MRI brain shows a left lateral medullary infarct. Which vascular territory is affected?

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Correct answer: C — Left posterior inferior cerebellar artery

Explanation lettering: E = shown as A · A = shown as E

Lateral medullary syndrome (Wallenberg syndrome) results from occlusion of the posterior inferior cerebellar artery (PICA) or the vertebral artery. Classic features include ipsilateral facial pain/numbness (trigeminal nucleus), contralateral body sensory loss, ipsilateral Horner syndrome, dysarthria, dysphagia, vertigo, nystagmus, and ipsilateral cerebellar ataxia. A/B: These are anterior circulation territories. D: AICA occlusion causes lateral pontine syndrome. E: Basilar artery occlusion typically causes bilateral signs.

Reference: RCP National Clinical Guideline for Stroke (2023)