Correlation of anatomy and function in medulla oblongata infarction
Article first published online: 9 DEC 2008
© 2008 The Author(s). Journal compilation © 2008 EFNS
European Journal of Neurology
Volume 16, Issue 2, pages 201–204, February 2009
How to Cite
Eggers, C., Fink, G. R., Möller-Hartmann, W. and Nowak, D. A. (2009), Correlation of anatomy and function in medulla oblongata infarction. European Journal of Neurology, 16: 201–204. doi: 10.1111/j.1468-1331.2008.02381.x
- Issue published online: 14 JAN 2009
- Article first published online: 9 DEC 2008
- Received 2 September 2008 Accepted 15 October 2008
- ipsilateral axial lateropulsion;
- magnetic resonance imaging lesion mapping;
- Wallenberg’s syndrome
Background: A presentation of all aspects of the dorsolateral medulla oblongata syndrome is clinically very rare to find. In most cases patients present with fragmentary symptoms, e.g. ipsilateral axial lateropulsion, nystagmus, dysarthria, dysphagia or hemiataxia. However, the clinical presentation and lesion anatomy at the level of the medulla oblongata is still unsatisfactory. The aim of this study was to correlate the functional deficit with structural MRI-data.
Methods: We included thirteen patients (eight male, five female, mean age 65.5) with medulla oblongata infarction with clinically predominant ipsilateral axial lateropulsion and correlated clinical with structural deficits.
Results: Magnetic resonance imaging lesion mapping demonstrated ipsilateral axial lateropulsion to result from lesions of the spinocerebellar tract, the inferior cerebellar peduncle or the inferior vestibular nucleus. Nystagmus was associated with lesions of the inferior vestibular nucleus, dissociated sensory loss with the spinothalamic tract and hemiataxia with the spinocerebellar tract.
Conclusions: Correlating dysfunction and lesion anatomy is a promising approach to enhance our knowledge on medulla oblongata topography.