🔣Wallenberg syndrome results from occlusion of either the vertebral artery or its branch, the posterior inferior cerebellar artery (PICA). Occlusion leads to lateral medullary infarction, which can affect multiple brainstem areas in the following ways:
– Lateral spinothalamic tract (purple): contralateral loss of pain and temperature sensation in the trunk and limbs
– Trigeminal nucleus (purple): ipsilateral loss of pain and temperature sensation in the face
– Vestibular nucleus (red): vertigo with falling to the affected side and nystagmus to the opposite side
– Inferior cerebellar peduncle (dark blue): ipsilateral ataxia and dysmetria
– Nucleus ambiguus (green): dysphagia, hoarseness, and a decreased gag reflex
– Sympathetic fibers (light blue): Horner syndrome
Nucleus ambiguss injury and damage to sympathetic fibers can both cause persistent hiccups.
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