Bulbar infarction syndrome

Bulbar infarction

In the posterior circulation, atherosclerosis tends to occur proximal vertebral arteries (VA), distal intracranial segments of vertebral arteries, lower-middle BA, and proximal

Clinical features

Lateral dorsal syndrome (LMI)

Dizziness and gait instability occur in more than 90% of patients, which may be due to

Involvement of the suspected nucleus results in dysphagia, dysarthria, and hoarseness

Sensory symptoms/signs are common, with only 4% of patients feeling normal

Medullary medullary infarction syndrome (MMI)

Dejerine proposed a triad of medial medullary infarction syndrome: contralateral central limb hemiplegia, without involvement of the facial nerve (pyramidal tract lesions); decreased or loss of contralateral deep sensation (medial thalamic damage); ipsilateral tongue muscle paralysis (damage to the sublingual nerves).

Contralateral central limb hemiplegia without facial nerve involvement is the most typical clinical manifestation of MMI

Sensory dysfunction is the second most important symptom/sign of MMI

Vertigo/dizziness, nystagmus, and ocular movement disorders are strongly associated

Significance of intracranial vertebral artery lesions in medulla oblongata syndrome

Medulla oblongata is mainly supplied by some of the punctural arteries from the intracranial vertebral arteries (ICVAs

Figure-1 88-year-old woman with a history of hypertension, clinical manifestations: dizziness and gait instability

Wallenberg initially thought that PICA lesions were the cause of lateral dorsal infarction of

For medullary ventral infarction syndrome, ASA occlusion was initially thought to be an important stroke mechanism

： ，