Because of the far more common origin from the vertebral artery, most "PICA" syndrome strokes actually areĭue to vertebral artery occlusion (Kim 2003). PICA may arise from the vertebral artery (the usual case), or as a separate branch of the basilarĪrtery. Usually LMS/Wallenberg's is caused by loss of blood flow in the posterior inferior cerebellar artery (PICA). Source of figure: what-when-how neuroscience. The "VN" is the inferior vestibular nucleus, more commonly labeled as either DVN or IVN. SVN,LVN,MVN are the superior,lateral and medial vestibular nuclei. It both supplies the medulla as well as the inferior cerebellum.Ĭentral vestibular pathways, drawn from back of brainstem with cerebellum removed. PICA is usually a branch of the vertebral artery. What causes Wallenberg's/Lateral Medullary syndrome ? Hearing symptoms are generally from strokes in the territory of he next higher artery in the brainstem, the anterior inferior cerebellar artery or AICA. LMS generally does not include hearing symptoms however. Opposite side weakness (Babinski-Nageotte)
Sympathetic connections descending from hypothalmus into cervical cord. These were divided up into the upper group (rostral) and the more common lower group (caudal). Kim (2003) provided a table including 18 symptoms (or categories) of symptoms.
In addition, there are a lot of important structures supplied by PICA, and depending where the damage lies, there may be other findings. With LMS almost always have a Horner's syndrome (acutely unilateral ptosis, miosis and facial anhidrosis), but partial Wallenberg's are more the rule than the exception. Very well and often resume their previous activities (Nelles et al, 1998). Hemiataxia, dysarthria, ptosis and miosis. Or "Wallenberg's syndrome", after Wallenberg's description in 1895. The PICAstroke syndrome is also known as "lateral medullary syndrome", PICA (posterior cerebellar artery syndrome).
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