Wallenberg Syndrome Secondary to Vertebral Artery Dissection

Abstract

Introduction: Wallenberg syndrome, or lateral medullary infarction, is usually caused by occlusion of the vertebral artery or the posterior inferior cerebellar artery (PICA), with vertebral artery dissection being an underdiagnosed etiology.

Objective: To present a case of Wallenberg syndrome secondary to vertebral artery dissection and perform a scoping review on its pathophysiology, diagnosis, and treatment.

Methods: A case report was prepared following CARE guidelines and a scoping review based on PRISMA-ScR methodology. PubMed, Scopus, and Google Scholar were searched for original studies, reviews, and case reports.

Results: A 71-year-old woman presented with right lateral medullary infarction due to vertebral artery dissection from V1 to V4. Conservative treatment was effective, followed by cervical discectomy. Eight relevant studies were included. MRI with DWI and angiography were the most useful diagnostic methods. No clear superiority between antiplatelet therapy and anticoagulation was found.

Conclusions: Vertebral artery dissection is a frequent and under-recognized cause of Wallenberg syndrome. Early neurovascular imaging and timely antithrombotic therapy are essential to improve functional outcomes.