Lateral medullary infarction with cardiovascular autonomic dysfunction: an unusual presentation with review of the literature

Huynh, Tridu R.; Decker, Barbara; Fries, Timothy J.; Tunguturi, Ajay

doi:10.1007/s10286-018-0502-6

Cited by 12 publications

(10 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Twenty percent of ischemic events in the brain involve posterior circulation (vertebrobasilar). LMS is the most common syndrome caused by occlusion of the intracranial vertebral artery, the PICA, followed by the medullary artery [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

A case report: Lateral medullary syndrome with facial nerve palsy and hemiparesis

Shrestha

Kharel²,

Acharya³

et al. 2022

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

A case report: Lateral medullary syndrome with facial nerve palsy and hemiparesis

Shrestha

Kharel²,

Acharya³

et al. 2022

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

“…The reason for this is uncertain, and further study is required to determine patients who are at risk for clinically relevant cardiac arrhythmias and who require additional monitoring. Interestingly, our observation that the mean QTc was highest on the day of presentation with QTc shortening on subsequent days suggests that QTc‐prolongation is a transient phenomenon after lateral medullary infarction, which could partly explain the relative infrequency of cardiac dysfunction after lateral medullary infarction 13,14 …”

Section: Discussionmentioning

confidence: 93%

“…Interestingly, our observation that the mean QTc was highest on the day of presentation with QTc shortening on subsequent days suggests that QTc-prolongation is a transient phenomenon after lateral medullary infarction, which could partly explain the relative infrequency of cardiac dysfunction after lateral medullary infarction. 13,14 Strengths of our study include the unbiased approach to lesion mapping and overlay with standardized atlas to identify specific anatomical structures related to QTc-prolongation. Inclusion of patients presenting within 4.5 hours may have increased the chance to determine early and potentially reversible QTc-prolongation.…”

Section: Discussionmentioning

confidence: 99%

Dorsal vagal nucleus involvement relates to QTc‐prolongation after acute medullary infarction

Sun

Keyhanian

et al. 2021

Acta Neuro Scandinavica

View full text Add to dashboard Cite

Background Infarction of the medulla has been associated with prolongation of the QTc, severe arrhythmia, and sudden cardiac death, yet the precise anatomical substrate remains uncertain. Aims We sought to determine the possible anatomical structures relating to QTc‐prolongation in patients with acute medullary infarction. Methods We included 12 subjects with acute ischemic medullary infarction on brain MRI, who presented within 4.5 h from the last known well time, with a 90‐day follow‐up. For an unbiased lesion analysis, medullary infarcts were manually outlined on diffusion weighted MRI and co‐registered with an anatomical atlas. Results Nine out of 12 had QTc‐prolongation. Qualitative and semi‐quantitative comparisons were made between infarct location and QTc‐prolongation. Among patients with QTc‐prolongation, the greatest degree of congruence of the infarct location was over the dorsal vagal nucleus (DVN, 8 out of 9). There was a significant correlation between the number of sections showing infarction of the DVN and presence of QTc‐prolongation (r = .582, p = .047). Among patients without QTc‐prolongation, the maximum lesion overlap included the medial aspect of the gigantocelluar reticular nucleus of the reticular formation. Conclusion We found that the DVN is a key anatomical substrate related to QTc‐prolongation. Further studies with more patients and high‐resolution, volumetric MRI are needed to confirm our findings.

show abstract

“…(v) Lateral type (5): the superficial region of the lateral caudal medulla without extending dorsally [2,5]. The large arteries are the extracranial cerebral arteries (carotid and vertebral arteries) and intracranial muscular arteries coursing through the subarachnoid space [6]. The small vessels are the deep perforating arteries and superficial perforating arteries that penetrate the brain tissue [6].…”

Section: Methodsmentioning

confidence: 99%

Clinico-Radiological Profile of Patients With Lateral Medullary Syndrome: A Five Years Observation From a Single-Centered Tertiary Hospital in Nepal

Shrestha¹,

Pandit²,

Acharya³

et al. 2022

Cureus

View full text Add to dashboard Cite

Objective: We aim to correlate the prevalence of symptoms of the lateral medullary syndrome (LMS) based on radiological classification. Methods: A five-year record of 41 patients diagnosed with LMS and admitted to a tertiary care center in Nepal was reviewed. We used chi-square tests to compare symptoms between rostral and caudal groups and different horizontal subtypes. Results: The subtype prevalence in the horizontal classification of LMS was large (31.7%), lateral (22%), dorsal (19.5%), typical (14.6%), and ventral (12.2%). The most common symptoms in the typical subtype of the horizontal classification were: pain/temperature loss in the contralateral body (7.3%) and dysphagia (7.3%); in the ventral subtype, swaying on the Romberg test (12.2%), dysarthria (9.8%) and dizziness (9.8%); in the dorsal subtype, headache (12.2%) and vomiting (12.2%). Whereas headache (22.2%) and lateropulsion on standing (14.6%), swaying on the Romberg test (14.6%), nausea/vomiting (14.6%) were common in the large subtype, and nausea/vomiting (19.5%) and headache (17.1%) in the lateral subtypes. Whereas, in rostrocaudal classification, the rostral subtype (61%) was more common than the caudal subtype (31%). There was no significant variation in symptoms based on the rostrocaudal classification of LMS. Conclusion: The common clinical manifestations are different for different radiological subtypes of LMS. Further comprehensive studies are essential to understand the prevalence of symptoms in different radiological subtypes and the clinical-radiologic correlation in LMS.

show abstract

Lateral medullary infarction with cardiovascular autonomic dysfunction: an unusual presentation with review of the literature

Cited by 12 publications

References 38 publications

A case report: Lateral medullary syndrome with facial nerve palsy and hemiparesis

A case report: Lateral medullary syndrome with facial nerve palsy and hemiparesis

Dorsal vagal nucleus involvement relates to QTc‐prolongation after acute medullary infarction

Clinico-Radiological Profile of Patients With Lateral Medullary Syndrome: A Five Years Observation From a Single-Centered Tertiary Hospital in Nepal

Contact Info

Product

Resources

About