![]() 9, 10 The medullary raphe contains a narrow sheet of cells in the midline of the medulla that extends caudally from a level to the rostral pole of the facial nucleus to the level of the pyramidal decussation. 8 In the brain stem medulla, the medullary raphe and RVLM are important structures in controlling cutaneous vasomotor activity for thermoregulation. The hypothalamus, which receives information from cutaneous and internal thermoreceptors and sends efferent signals to thermoregulatory effector organs, plays a key role in controlling body temperature. One patient with lateralized BST had a rostral medullary infarction and the other had a typical or large middle medulla infarction. Taken together, two patients without lateralized BST had a lateral caudal medullary infarction, and one patient had a dorsal middle medullary infarction. One patient with lateralized BST showed a rostral medullary infarction ( Fig. Four patients with lateralized BST showed middle medulla-typical ( Fig. 4A) or a middle medulla-dorsal type ( Fig. In the left LMI group, two patients with no lateralized BST showed a caudal medulla-lateral type ( Fig. 3A), had a small caudal medullar infarction (caudal medulla-lateral type) and patients with lateralized BST had a larger middle medullary infarction (middle medulla-typical in Fig. ![]() 1 In the right LMI group, one patient with no lateralized BST ( Fig. In this study, the lesions were categorized rostrocaudally and horizontally according to the LMI classification system. ![]() MRI revealed that the medullary lesions were on the right in five patients and on the left in seven patients. ![]() 6 This study aimed to investigate the relationship between the laterality of BST and brain magnetic resonance imaging (MRI) findings in 12 patients with WS.īrain MRI and diffusion-weighted imaging were performed in all patients. We presumed that the laterality of BST and sensory dysfunction in patients with WS may be associated with the disturbance of the cutaneous vasomotor activity of skin blood flow descending from the rostral ventrolateral medulla oblongata (RVLM). 6, 7 Our study showed that patients with sensory dysfunction in WS had lateral BST differences, which were detected by infrared thermography. 4, 5 We have previously reported the laterality of skin temperature depending on sensory symptoms in patients with WS. 2, 3 Recently, the lateral difference in body surface temperature (BST) has been reported as a symptom of WS, resulting from disturbances of the sympathetic nerve pathway. 1 Clinical symptoms of WS include hoarseness, dysphagia, sensory disturbance, vertigo, ataxia, and Horner’s syndrome. Wallenberg syndrome (WS) is caused by dorsal lateral medullary infarction (LMI) that results from occlusion of the vertebral artery or posterior inferior cerebellar artery (PICA). ![]()
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