(Posterior inferior cerebellar artery is PICA.) File:Human brainstem blood supply description.JPG The three major arteries of the cerebellum: the SCA, AICA, and PICA. Ipsilateral Horner's syndrome (ptosis, miosis, & anhydrosis) Ipsilateral laryngeal, pharyngeal, and palatal hemiparalysis: dysphagia, hoarseness, diminished gag reflex (efferent limb - CN.X) Nucleus ambiguus - (which affects vagus nerve and glossopharyngeal nerve - localizing lesion (all other deficits are present in lateral pontine syndrome as well) Ipsilateral loss of pain, and temperature sensation from face Ipsilateral cerebellar signs including ataxia, dysmetria (past pointing), dysdiadokokinesiaĬontralateral deficits in pain and temperature sensation from body (limbs and torso) Vestibular system: vomiting, vertigo, nystagmus, Palatal myoclonus may be observed due to disruption of the central tegmental tract.Ĭlinical B1000 diffusion weighted MRI image showing an acute left sided dorsal lateral medullary infarct Features Features of lateral medullary syndrome Onset is usually acute with severe vertigo. Nystagmus and vertigo, which may result in falling, caused from involvement of the region of Deiters' nucleus and other vestibular nuclei. Damage to the hypothalamospinal fibers disrupts sympathetic nervous system relay and gives symptoms analogous to Horner syndrome. The damage to the cerebellum or the inferior cerebellar peduncle can cause ataxia. The spinothalamic tract is damaged, resulting in loss of pain and temperature sensation to the opposite side of the body. Damage to the spinal trigeminal nucleus causes absence of pain on the ipsilateral side of the face, as well as an absent corneal reflex. This crossed finding is diagnostic for the syndrome.Ĭlinical symptoms include difficulty swallowing, or dysphagia, slurred speech, ataxia, facial pain, vertigo, nystagmus, Horner syndrome, diplopia, and possibly palatal myoclonus.Īffected persons have difficulty in swallowing ( dysphagia) resulting from involvement of the nucleus ambiguus, as well as slurred speech ( dysarthria)and disordered vocal quality ( dysphonia ). Specifically, there is a loss of pain and temperature sensation on the contralateral (opposite) side of the body and ipsilateral (same) side of the face. (From Adams et al.This syndrome is characterized by sensory deficits affecting the trunk ( torso) and extremities on the opposite side of the infarction and sensory deficits affecting the face and cranial nerves on the same side with the infarct. Clinical manifestations vary with the size of infarction, but may include loss of pain and temperature sensation in the ipsilateral face and contralateral body below the chin ipsilateral HORNER SYNDROME ipsilateral ATAXIA DYSARTHRIA VERTIGO nausea, hiccup dysphagia and VOCAL CORD PARALYSIS. It is caused by occlusion of the VERTEBRAL ARTERY and/or the posterior inferior cerebellar artery. INFARCTION of the dorsolateral aspect of MEDULLA OBLONGATA in the BRAIN STEM. Patients experience difficulty swallowing and/or speaking. It is characterized by sensory defects affecting the same side of the face as the infarct and the opposite side of the trunk as the infarct. A syndrome caused by an infarct in the vertebral or posterior inferior cerebellar artery.

Pica syndrome cerebellum