A 55-year-old man presents with ipsilateral loss of pain and temperature sensation on the face, contralateral loss of pain and temperature on the body, ipsilateral Horner syndrome, dysphagia, and ipsilateral cerebellar ataxia. Which artery is most likely occluded?
- A Anterior inferior cerebellar artery (AICA)
- B Superior cerebellar artery
- C Posterior inferior cerebellar artery (PICA) ✓
- D Basilar artery
Explanation
The constellation of ipsilateral facial pain/temperature loss, contralateral body pain/temperature loss, Horner syndrome, dysphagia, and cerebellar ataxia constitutes Wallenberg (lateral medullary) syndrome caused by PICA or vertebral artery occlusion. The infarcted territory includes the spinal trigeminal nucleus/tract (ipsilateral face), spinothalamic tract (contralateral body), sympathetic fibers descending to ciliospinal center (Horner), nucleus ambiguus (dysphagia), and inferior cerebellar peduncle. AICA occlusion also produces lateral pontine syndrome but classically includes ipsilateral facial palsy and hearing loss.
Reference: BD Chaurasia's Human Anatomy, 8th ed.
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Written and medically reviewed by the StethoPrep medical team.