축의 측방돌진이 우세한 첫 증상으로 나타난 외측 연수경색
Lateral Medullary Infarction Presented with Axial Lateropulsion as a Predominant Initial Symptom
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Axial lateropulsion has been described as one of the symptoms of lateral medullary infarction (LMI). However, isolated body lateropulsion without other medullary symptoms is unusual in LMI. Here, we report a case of LMI presented with ipsilateral axial lateropulsion as a prominent presenting symptom. A 64-year-old man came to our department because of his unsteady gait. Neurological examination revealed axial lateropulsion to the right and mild gaze-evoked nystagmus to the left. The other neurological examination was unremarkable. Brain MRI indicated an acute lesion on the right lateral medulla. In addition, CT angiography denoted an occlusion in the distal portion of the right vertebral artery. He was treated with aspirin 100 mg daily. His lateropulsion improved gradually within two weeks. Axial lateropulsion may occur in LMI owing to the involvement of the vestibular pathway, spinocerebellar tract, or olivocerebellar climbing fiber. (Korean J Stroke 2007;9:165-167)
Abstract
Axial lateropulsion has been described as one of the symptoms of lateral medullary infarction (LMI). However, isolated body lateropulsion without other medullary symptoms is unusual in LMI. Here, we report a case of LMI presented with ipsilateral axial lateropulsion as a prominent presenting symptom. A 64-year-old man came to our department because of his unsteady gait. Neurological examination revealed axial lateropulsion to the right and mild gaze-evoked nystagmus to the left. The other neurological examination was unremarkable. Brain MRI indicated an acute lesion on the right lateral medulla. In addition, CT angiography denoted an occlusion in the distal portion of the right vertebral artery. He was treated with aspirin 100 mg daily. His lateropulsion improved gradually within two weeks. Axial lateropulsion may occur in LMI owing to the involvement of the vestibular pathway, spinocerebellar tract, or olivocerebellar climbing fiber. (Korean J Stroke 2007;9:165-167)