Management of a patient with Opalski's syndrome in intensive care unit

Abstract

Key Clinical Message Opalski syndrome is a rare vascular brainstem syndrome which is accepted as a variant of Wallenberg syndrome. Opalski syndrome should be considered in acute conditions in which typical symptoms of lateral medullary infarct are accompanied by ipsilateral hemiparesis. Other brain stem syndromes are distinguished from Opalski syndrome by the presence of contralateral hemiparesis.

Comorbid SUNCT Syndrome and Opalski Syndrome Caused by Dorsolateral Medullary Infarction

“…Thirdly, the involvement of pyramidal fibers may be in the border-zone area between the anterior and posterior spinal arteries, and fail to get enough blood supply due to artery occlusion or stenosis (11). Lastly, some people think hemiparesis may be a result of spinocerebellar hypotonic syndrome (12). A study using diffusion tensor imaging techniques and superimposed images to generate a directionally encoded color map, suggested Opalski syndrome may arise as a consequence of ipsilateral corticospinal tract involvement after the pyramidal decussation, or compression of the decussation (9).…”

Dorsolateral medullary infarction registry: a study protocol for a prospective, multicentric registry

“…While treating cerebral infarction, we will pay attention to the prophylaxis of the post-stroke complications, including administering low-molecular weight heparin for deep vein thrombosis, enteral nutrition for consumption and misinhalation, gastric mucosa protection for Cushing ulcer, antibiotic treatment for ventilator-associated pneumonia, and catheter-associated urinary tract infection, among others. If the condition permits, related examinations will be performed early on [ 20 , 21 ].…”

“…Meanwhile, we will ask patients to control hazard factors, such as hypertension, hyperglycemia, hyperlipemia, hyperhomocysteinemia, and obesity. Due to a high incidence of cardiopulmonary arrest, the importance of managing DLMI will be kept in mind by each clinician and nurse as early as the first reception [20,21]. Patients who are diagnosed with DLMI will be admitted to the intensive care unit, and the relatives of patients will be informed of the patient's condition.…”

Síndrome medular lateral con hemiplejía ipsilateral; síndrome de Opalski. Reporte de caso y revisión de la literatura

“…Cuando en el síndrome de Wallenberg se asocia hemiplejia ipsilateral, se habla del síndrome de Opalski. Algunos reportes neuropatológicos han demostrado que el sitio de infarto es más bajo comparado con aquellos reportes de síndrome de Wallenberg 6,7 .…”

“…Este síndrome es más frecuente en hombres con una relación 3:1 respecto a mujeres, a partir de los 45 años, con presentación promedio a los 60, los factores de riesgo inmplicados son tabaquismo, hipertensión, diabetes tipo 2, hiperlipidemias y antecedente de cardiopatía 3,4 . El alcohol no se ha establecido como un factor de riesgo para infarto de la fosa posterior, sin embargo un estudio reportó que la incidencia de este tipo de infartos es el doble de alto en pacientes alcohólicos comparados con la población general 6,7 . Hasta el momento en que se realiza esta revisión, no existen datos estadísticos acerca de la frecuencia de presentación de esta entidad clínica.…”