A case of bilateral medial medullary infarction caused by unilateral vertebral artery dissection

Takayoshi Akimoto, Makoto Hara, Mari Saito, Keiko Takahashi, Satoshi Kamei

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

A 34-year-old man developed right neck pain. Several hours later, he felt numbness of his extremities and presented at our hospital. He developed right hemiparesis and hypoesthesia of the right extremities. A few hours later, upbeat nystagmus and dysarthria appeared along with a sensory disturbance that spread to all extremities, and right hemiparesis progressed to tetraplegia. Brain MR diffusion-weighted images revealed a high-intensity lesion in the bilateral medial medulla oblongata and we diagnosed this bilateral medial medullary infarction. Three dimentional CT angiography revealed dissection of the right VA. We administered intravenous argatroban, edaravone, glycerin and oral clopidogrel. He was assessed as having modified Rankin scale 4 and was transferred to another hospital for rehabilitation on day 30. When the medial medulla oblongata is supplied by the unilateral VA, a unilateral VA dissection can cause bilateral medial medullary infarction. (Rinsho Shinkeigaku (Clin Neurol) 2015;55:748-752).

Original languageEnglish
Pages (from-to)748-752
Number of pages5
JournalClinical Neurology
Volume55
Issue number10
DOIs
Publication statusPublished - 2015

Keywords

  • Bilateral medial medullary infarction
  • Heart appearance
  • Neck pain
  • Pearl and string sign
  • Three dimentional ct angiography

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