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The medulla contains complex nervous structures related to motor, sensory, coordination,
and visceral autonomic functions. The medullary infarctions cause various symptoms
and signs depending on the location of the lesion. Lateral medullary infarction is
caused by a vascular event in the territory of the posterior inferior cerebellar artery
or the vertebral artery [
]. We report a case of a patient with falling tendency and whirling sensation. He reported
no facial drop, arm drift, slurred speech, difficulty of swallowing, or weakness of
his limbs. The neurologic examination revealed no decreased muscle power, dysarthria,
dysphagia, or other relevant neurologic deficits. Urgent noncontrast brain computed
tomography detected no acute hemorrhage or ischemic lesion. On admission, the oculomotor
examination revealed conjugated rotational nystagmus with clockwise direction. The
magnetic resonance imaging of the brain demonstrated acute infarct in the medulla
oblongata approximately 0.8 × 0.5 cm. The infarct appears bright on diffusion-weighted
images (Fig.). A diagnosis of dorsolateral medulla infarction was established, and the patient
was started on a therapy of 100 mg aspirin once daily. After standard therapies, the
patient's recovery was uneventful.
FigThe dorsolateral medulla oblongata infarct appears bright on diffusion-weighted images.
