• The Journal of Internal Korean Medicine
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• v.21 no.3
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• pp.521-524
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• 2000

Wallenberg's syndrome is well known of dorsolateral medullary syndrome. A 56-year-old women was admitted because vertigo, vomitting, vertiginous ataxia, ipsilateral loss Rt. face and Lt. lower limb sense. The result of all performed laboratory tests were normal, but Sr-MRI scan was right lateral medullary infarction. And Br-MRA was focal stenosis of Lt. ICA. We present here one case of Wallenberg's syndrome, who was admitted at Kyungwon University Hospital From 25th Apr. to 21th May. 1998.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.768-775
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• 2019

Objective: The aim of this study was to report a case in which Korean medicine treatment with Gami-daebo-tang and acupuncture improved the clinical symptoms in a patient with Wallenberg syndrome. Methods: The patient was treated for 53 days with a Korean medicine treatment consisting of Gami-daebo-tang and acupuncture. We measured dysesthesia based on the number of affected dermatomes. Gait ataxia was estimated with the Korean version of the Berg Balance Scale (K-BBS) and the number of times that the patient had stumbled per day. Dizziness was measured with a numerical rating score (NRS). Results: After treatment, the number of affected dermatomes was decreased. The K-BBS score was improved from 52 to 56, and the frequency of stumbling decreased from 20 to 0 times per day. The NRS score of dizziness decreased from 8 to 0. Conclusion: This case showed that Korean medicine treatment might be helpful for improving the symptoms of patients with Wallenberg syndrome.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.221-225
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• 2009

Objective : Surgical treatment of posterior inferior cerebellar artery (PICA) aneurysms is challenging due to limited surgical accessibility. Endovascular approach has a benefit of avoiding direct injury to the brainstem or lower cranial nerves. Therefore, it has recently been considered an alternative or primary modality for PICA aneurysms. We retrospectively assessed outcomes following detachable coil embolization of saccular PICA aneurysms. Methods : From February 1997 to December 2007, we performed endovascular procedures to treat 15 patients with 15 PICA aneurysms. Fourteen patients with 14 PICA aneurysms morphology of which was saccular were reviewed retrospectively. Twelve patients had ruptured aneurysms. The aneurysms arose from the PICA origin site (n=12), the PICA lateral medullary segment (n=1), or the PICA tonsilomedullary segment (n=1). Results : Complete aneurysm occlusion was achieved in 10 patients, residual neck in 3, and residual sac in one. Radiological follow-up was performed in 7 patients with mean duration of 34.7 months (range, 1-97 months) and showed stable or complete occlusion in 6 patients. There were no rebleeding or retreatment after endovascular treatment. Thromboembolism was the only procedure-related complication (n=4 ; 28.6%). Asymptomatic PICA infarction occurred in two patients and symptomatic PICA infarction in two elderly patients with poor clinical grade. Of these procedural PICA infarction cases, 1 symptomatic PICA infarction patient developed ventriculitis and septic shock leading to death. The clinical outcome was good in 10 patients (71.4%). Conclusions : In the present study, detachable coil embolization has shown as an efficient modality for PICA saccular aneurysms challenging indications of microsurgery. However, thromboembolic complications should be considered, especially in poor clinical elderly patients with ruptured aneurysms.

• The Journal of the Society of Stroke on Korean Medicine
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• v.10 no.1
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• pp.62-67
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• 2009

Wallenberg's syndrome is a neurological condition caused by a stroke in the vertebral or posterior inferior cerebellar artery of the brain stem. Wallenberg's syndrome is also called Lateral Medullary Syndrome. In this case report, we are going to describe the clinical menifestation and progress of one case of Wallenberg's syndrome and review previously published case reports about it and compare them to our case. In conclusion, significant improvements were observed in some symptoms but there were some symptoms not improved such as paresthesia. So further researches are needed for more effective treatment.

• Investigative Magnetic Resonance Imaging
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• v.18 no.1
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• pp.17-24
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• 2014

Purpose : To determine whether high-resolution contrast-enhanced three dimensional imaging with spoiled gradient-recalled sequence (HR-CE 3D-SPGR) plays a meaningful role in the assessment of intracranial vertebral artery (ICVA) and posterior inferior cerebellar artery (PICA) in lateral medullary infarction (LMI). Materials and Methods: Twenty-five patients confirmed with LMI were retrospectively enrolled with approval by the IRB of our institute, and 3T MRI with HR-CE 3D-SPGR and contrast-enhanced magnetic resonance angiography (CE-MRA) were performed. Two radiologists who were blinded to clinical information and other brain MR images including diffusion weighted image independently evaluated arterial lesions in ICVA and PICA. The demographic characteristics, the area of LMI and cerebellar involvement were analyzed and compared between patients with arterial lesion in ICVA only and patients with arterial lesions in both ICVA and PICA on HR-CE 3D-SPGR. Results: Twenty-two of twenty-five LMI patients had arterial lesions in ICVA or PICA on HR-CE 3D SPGR. However twelve arterial lesions in PICA were not shown on CE-MRA. Concurrent cerebellar involvement appeared more in LMI patients with arterial lesion in ICVA and PICA than those with arterial lesion in ICVA alone (p = 0.069). Conclusion: HR-CE 3D-SPGR can help evaluate arterial lesions in ICVA and PICA for LMI patients.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.3
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• pp.278-283
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• 2020

Central sleep apnea (CSA) is characterized by respiratory failure of at least 10 seconds without any effort of the chest and abdomen in the absence of upper airway resistance during sleep. In this case, the patient experiences respiratory failure that does not meet the CSA diagnostic criteria and CSA symptoms. Magnetic resonance imaging diffusion-weighted imaging (MRI DWI) scans revealed a lateral medullary infarction. Continuous positive airway pressure (CPAP) was applied as a primary treatment for CSA and respiratory failure. During the titration of CPAP, the apnea-hypopnea index (AHI) and arousal index (AI) were worse than the results before its use (AHI: 42.5/hr→82.8/hr, AI: 21.7/hr→40.8h). As a result, adaptive servo-ventilation (ASV) was chosen as the secondary treatment. Compared to the night-polysomnography results before the ASV treatment, the AHI improved (42.5/hr→8.6/hr). Therefore, ASV is a potential treatment for CSA and respiratory failure in these patients.

• The Journal of Internal Korean Medicine
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• v.25 no.2
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• pp.335-343
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• 2004

The two case reports here presented are based on an inpatient with lateral medullary infarction, known as Wallenberg's syndrome with chief complains of central dizziness and cerebellar ataxia, and an inpatient with infarctions of cerebellar, pontine, and lacunar thalamic region. QSCCII was performed while the patient was hospitalized and, by consultation with the Dept. of Sasang Constitutional Medicine, the patient was diagnosed with Taeumin. Thus, an oriental medical therapy of Cheongsimyeonjatang, acupuncture, and moxibustion was carried out. As a result the degree of dizziness decreased noticeably while other symptoms improved as well. Before leaving the hospital, the degree of cerebellar ataxia also improved and the patient was able to go on foot by himself. In conclusion, significant improvements were observed in cerebellar and a pontine infarction patients who suffered central dizziness and cerebellar ataxia through Sasang medical therapy.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.4
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• pp.107-115
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• 2016

The occurrence of brain stem stroke after lumbar selective nerve root block seem to be an uncommon event comparing it to after cervical selective nerve root block. We recently experienced a 60-year-old man who were diagnosed as left lateral medullary infarction (Wallenberg's syndrome) after lumbar selective nerve root block. He was treated by traditional Korean medicine with acupunture, Pulsed electromagetic therapy (PEMT), herb medicine. The range of motion of upper and lower extremity, manual muscle test, Korean version of Berg balance scale (K-BBS) and Korean version of Barthel index (K-MBI) were adopted to measure the resulting recovery after 4 weeks treatment. Traditional Korean medicine was effective for rehabilitation of patient. Further studies are needed to set up and Korean medical protocol for Wallenberg's syndrome.