Which are the causes of Wallenberg Syndrome?

Wallenberg Syndrome, also known as lateral medullary syndrome or posterior inferior cerebellar artery (PICA) syndrome, is a neurological condition that results from damage to the brainstem. It is named after the Swedish neurologist, Adolf Wallenberg, who first described the syndrome in 1895. Wallenberg Syndrome is characterized by a range of symptoms that can vary in severity depending on the extent and location of the brainstem damage.

The main cause of Wallenberg Syndrome is a blockage or occlusion of the posterior inferior cerebellar artery, which supplies blood to the brainstem. This blockage can occur due to various reasons:

1. Thrombosis: A blood clot forms within the blood vessel, blocking the flow of blood to the brainstem. Thrombosis can be caused by factors such as atherosclerosis (build-up of plaque in the arteries), high blood pressure, or blood clotting disorders.



2. Embolism: A blood clot or other debris forms elsewhere in the body (such as the heart) and travels through the bloodstream until it reaches a smaller blood vessel in the brainstem, causing a blockage. Embolism can occur due to conditions like atrial fibrillation (irregular heart rhythm) or cardiac abnormalities.



3. Arterial dissection: The inner lining of the artery tears, allowing blood to enter the arterial wall and form a clot, which can then block blood flow. Arterial dissection can be caused by trauma, connective tissue disorders, or spontaneous vessel wall weakness.



4. Other causes: In rare cases, Wallenberg Syndrome can also result from other conditions such as tumors, infections, or inflammation affecting the brainstem.

The blockage of the posterior inferior cerebellar artery leads to inadequate blood supply to specific areas of the brainstem, particularly the lateral medulla oblongata. This region is responsible for coordinating various functions, including sensation, movement, and autonomic functions.

The symptoms of Wallenberg Syndrome can vary depending on the exact location and extent of the brainstem damage. Common symptoms include:

• Dysphagia: Difficulty swallowing or a feeling of food getting stuck in the throat.


• Dysarthria: Slurred or difficult-to-understand speech.


• Vertigo: A spinning sensation or dizziness.


• Nystagmus: Involuntary eye movements, often horizontal or rotary.


• Ataxia: Lack of coordination and unsteady movements.


• Horner syndrome: A combination of symptoms including drooping eyelid, constricted pupil, and decreased sweating on one side of the face.


• Decreased pain and temperature sensation: Loss of sensation on one side of the face, trunk, and limbs.


• Hiccups: Involuntary contractions of the diaphragm.


• Hoarseness: Abnormal voice changes, often characterized by a raspy or weak voice.

Diagnosis of Wallenberg Syndrome involves a thorough neurological examination, medical history review, and imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scans. Treatment focuses on managing the symptoms and addressing the underlying cause, if possible. Rehabilitation therapies, including speech therapy, physical therapy, and occupational therapy, can help improve function and quality of life for individuals with Wallenberg Syndrome.

In conclusion, Wallenberg Syndrome is primarily caused by a blockage of the posterior inferior cerebellar artery, leading to brainstem damage. The most common causes of this blockage are thrombosis, embolism, arterial dissection, and, rarely, other conditions. The resulting symptoms can vary but often include difficulties with swallowing, speech, balance, and sensation. Early diagnosis and appropriate management can help individuals with Wallenberg Syndrome regain function and improve their overall well-being.