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ENT · Vestibular disorders: lateral medullary syndrome
Sample itemA 62-year-old hypertensive man has sudden vertigo, hoarseness, left Horner syndrome, loss of pain and temperature on the left face and the right body. Which vessel is involved?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Left posterior inferior cerebellar or vertebral artery
Wallenberg's syndrome follows infarction of the lateral medulla due to vertebral or PICA occlusion. It causes vertigo, nystagmus, dysphagia, ipsilateral Horner syndrome and ipsilateral facial with contralateral body sensory loss. AICA infarction causes facial paralysis and deafness.
Option by option
A. Basilar tip
Basilar tip occlusion gives midbrain and thalamic signs.
B. Left anterior inferior cerebellar artery
AICA lesion gives ipsilateral facial palsy and hearing loss.
C. Left posterior inferior cerebellar or vertebral artery (correct)
Correct. Lateral medullary infarction is a PICA or vertebral lesion.
D. Left middle cerebral artery
MCA lesion gives contralateral hemiparesis and aphasia.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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