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[Crossed pattern of sensory loss with left thoracic level in a right dorsolateral medullary infarction]

F Ruiz-Miyares1, R Kuriakose, D Deleu

  • 1Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. fruizelo@gmail.com

Revista De Neurologia
|October 9, 2008
PubMed
Abstract

Insights

Lateral medullary infarctions can cause sensory dysfunction. This case highlights an unusual crossed pattern of sensory loss in a patient with right lateral medullary infarction, indicating spinothalamic tract involvement.

Area of Science:

  • Neurology
  • Neuroscience
  • Stroke Medicine

Background:

  • Medullary infarctions, often from vertebro-basilar strokes, are common.
  • The medulla oblongata's compact structure means small lesions cause significant symptoms.
  • Sensory deficits are typical in lateral medullary infarctions, varying with lesion location.

Observation:

  • A 65-year-old man presented with sensory loss.
  • The patient experienced a left-sided pain and temperature sensory level up to T4.
  • This was attributed to a right lateral medullary infarction in the ipsilateral PICA territory.

Findings:

  • The case demonstrated a crossed pattern of sensory loss.
  • This unusual presentation suggests involvement of the spinothalamic tract's external aspect.
  • Right lateral medullary infarction led to contralateral sensory deficits.

Implications:

  • This presentation expands understanding of sensory pathway involvement in medullary strokes.
  • It underscores the importance of considering the spinothalamic tract's anatomy in diagnosing medullary infarctions.
  • Clinicians should be aware of unusual sensory patterns in lateral medullary infarction cases.

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