WALLENBERGS SYNDROME DUE TO A DISSECTING ANEURYSM OF THE VERTEBRAL ARTERY

Abstract

A 54 yr old man without pathologic past history but mild hypertension, obesity and gastric ulcer, suffered from Wallenberg syndrome. He had complained for 5 days of a progressive and diffuse headache. The neurological condition improved initially, but the patient died suddenly 2 wk later. Pathological examination showed no significant alteration except for all left ventricular enlargement amd mild arteriosclerosis. There was a hemodissection (dissecting aneurysm) of the left vertebral artery next to the inferior oliva. It induced a lateral infarct and a limited dorsal infarct at the middle 3rd level of the medulla oblongata. Although the location of the arterial changes in usual, their nature is exceptional. The cause of the arterial hemodissection could not be ascertained: fibrous arterial dysplasia, atherosclerosis or congential abnormalities of internal elastic layer may be discussed, but no definite conclusion can be reached.