Summary
Hemi-infarction of the medulla causes the clinical constellation of symptoms and signs of both the lateral and medial medullary syndromes and nearly always results from occlusion of an intracranial vertebral artery. In the case reported here, with a clinical diagnosis of hemimedullary syndrome, the expected infarction was imaged by magnetic resonance. A review of the literature confirms that the hemimedullary syndrome, in which both medial and lateral syndromes occur simultaneously, is extremely rare, since it yielded only two previous cases with adequate anatomical confirmation.
This is a preview of subscription content, log in via an institution to check access.
References
Amielanczyk W (1979) A case of Wallenberg-Babinski-Nageotte syndrome with longstanding dysphagia intensified by cervical spine degenerative changes. Wiad Lek 32:643–645
Babinski J, Nageotte J (1902) Hémiasynergie, latéropulsion et myosis bulbaires avec hémianesthésie et hémiplégie croisées. Rev Neurol (Paris) 10:358–365
Babinski J, Nageotte J (1902) Lésions syphilitiques des centres nerveux. Foyers de ramollissement dans le bulbe. Hémiasynergie, latéropulsion et myosis bulbaires avec hémianesthésie et hémiplégie croisées. Nouv Iconogr Salpêt 15:492–512
Bogorodinski DK, Pojarisski KM, Rasorenova RA, Skoromets AA (1968) Sur le syndrome de Babinski et Nageotte (pathogénic et corrélation avec autres syndromes alternes). Rev Neurol (Paris) 119:505–512
Bogousslavsky J, Fox AJ, Barnett HJM, Hachinski VC, Vinitski S, Carey LS (1986) Clinico-topographic correlation of small vertebrobasilar infarct using magnetic resonance imaging. Stroke 17:929–938
Cestan R, Chenais I (1903) Du myosis dans certains lésions bulbaires en foyer. Gaz Hôp (Paris) 76:1229–1233
Chmielewski H, Olejniczak J, Mazurek M, Berkan L (1976) Wallenberg-Nageotte-Babinski syndrome. Wiad Lek 29:1457–1460
Chokroverty S, Rubino FA, Haller C (1975) Pure motor hemiplegia due to pyramidal infarction. Arch Neurol 32:647–648
Currier RD (1969) Syndromes of the medulla oblongata. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 2. Elsevier/North Holland, New York, pp 217–237
Davison C (1937) Syndrome of the anterior spinal artery of the medulla oblongata. Arch Neurol Psychiatry 37:91–107
Dejerine J (1914) Sémiologie des affections du système nerveux. Masson, Paris
Escourolle R, Hauw JJ, Der Agopian P, Trelles L (1976) Les infarctus bulbaires. Etude des lésions vasculaires dans 26 observations. J Neurol Sci 28:103–113
Faught E, Oh SJ (1985) Brain-stem auditory evoked responses in brain-stem infarction. Stroke 16:701–705
Fisher CM, Curry HB (1965) Pure motor hemiplegia of vascular origin. Arch Neurol 13:30–40
Fox AJ, Bogousslavsky J, Carey LS, Barnett HJ, Vinitski S, Karlik SJ, Vinuela F, Pelz DM, Hachinski V (1986) Magnetic resonance imaging of small medullary infarctions. AJNR 7:229–233
Harris TH, Hauser A (1931) Occlusion of the right posterior inferior cerebellar artery and right vertebral artery. Arch Neurol Psychiatry 26:396–400
Hauw, JJ, Der Agopian P, Trelles L, Escourolle R (1976) Les infarctus bulbaires. Etude systématique de la topographie lésionnelle dans 49 cas. J Neurol Sci 28:83–102
Ho KL, Meyer KR (1981) The medial medullary syndrome. Arch Neurol 38:385–387
Kase CS, Varakis JN, Stafford JR, Mohr JP (1983) Medial medullary infarction from fibrocartilaginous embolism to the anterior spinal artery. Stroke 14:413–418
Kawamura H, Amano K, Tanikawa T, Kawabatake H, Kubo O, Kitamura K, Ono Y (1986) Chronological changes in the blink reflex and MRI in a patient with lateral medullary infarction. No Shinkei Geka 14:1113–1119
Leestma JE, Noronha A (1976) Pure motor hemiplegia, medullary pyramidal lesion, and olivary hypertrophy. J Neurol Neurosurg Psychiatry 39:877–884
Marinesco G, Draganesco S (1923) Hémisyndrome bulbaire relevant d'un ramollissement de l'étage moyen du bulbe, suite de trombus de l'artère vertébrale droite. Ann Méd 13:1–19
Meyer JS, Herndon RM (1962) Bilateral infarction of the pyramidal tracts in man. Neurology 12:637–642
Paulson GW, Yates AJ, Paltan-Ortiz JD (1986) Does infarction of the medullary pyramid lead to spasticity? Arch Neurol 43:93–95
Pines L, Gilinsky E (1930) Zur Vaskularisation der Medulla oblongata. Arch Psychiatr Nervenkr 90:177–184
Reinhold H (1894) Beiträge zur Pathologie der acuten Erweichungen des Pons und der Oblongata. Zugleich ein Beitrag zur Lehre von der “bulbären Ataxie”. Dtsch Z Nervenheilkd 5:351–374
Ross MA, Biller J, Adams HP Jr, Dunn V (1986) Magnetic resonance imaging in Wallenberg's lateral medullary syndrome. Stroke 17:542–545
Trelles JO, Trelles L, Urquiaga C (1973) Le ramollissement médian du bulbe. A propos de deux cas anatomo-cliniques. Rev Neurol (Paris) 129:91–104
Wallenberg A (1895) Acute Bulbäraffection (Embolie der Art. cerebellar. post. inf. sinistr.). Arch Psychiatr Nervenkr 27:504–540
Wallenberg A (1901) Anatomischer Befund in einem als “Acute Bulbäraffection” (Embolie der Art. cerebellar.-post. inf. sinistr.) beschriebenen Falle. Arch Psychiatr Nervenkr 34:923–959
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mossuto-Agatiello, L., Kniahynicki, C. The hemimedullary syndrome: case report and review of the literature. J Neurol 237, 208–212 (1990). https://doi.org/10.1007/BF00314596
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00314596