A 52-year-old man presents with loss of pain and temperature sensation on the right side of his face and the left side of his body, with ipsilateral Horner syndrome and dysphagia. Which artery is most likely occluded?

• A Anterior inferior cerebellar artery (AICA)
• B Posterior inferior cerebellar artery (PICA) ✓
• C Basilar artery
• D Superior cerebellar artery

Explanation

Lateral medullary (Wallenberg) syndrome results from PICA occlusion. It causes ipsilateral facial pain/temperature loss (descending trigeminal nucleus), contralateral body pain/temperature loss (spinothalamic tract), ipsilateral Horner syndrome (descending sympathetic fibers), and dysphagia/dysphonia (nucleus ambiguus). AICA infarcts affect the pons and cause different clinical features including ipsilateral facial paralysis.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.