Rare conditions afflict a small section of global populations, and due to the lesser prevalence, affected patients often do not receive the most appropriate treatment. One such condition is the Wallenberg syndrome, that refers to the occurrence of an infarction or pica artery stroke. Occurring in the lateral medulla portion of the brain, this happens when oxygenated blood does not reach the brain stem due to blockage. As a result of this, the patient ends up with a stroke. Following subsections offer a detailed view of the condition and posterior inferior cerebellar artery to help patients and family members have complete information about the condition.

What is posterior inferior cerebellar artery?

This artery known by its acronym PICA, refers to the artery that facilitates flow of blood to the brain, The posterior inferior cerebellar artery (or PICA) is an artery that provides blood flow to the cerebellum, that part of the brain stem, responsible for functions related to movement a coordination. This artery is regarded as one of the most variable among all the arteries in the body, and comprises the supratonsillar segment, in addition to different medulla parts.

The artery has a role to facilitate movement of oxygenated blood. Specifically, the supply of blood is to the lower portion of a segment of the cerebellum known as the middle segment, apart from the lower portion of the medulla. The artery also supplies blood to a section known as the posteroinferior cerebellar hemispheres.

What happens when PICA is blocked?

When PICA is blocked, this could result in a sudden stoppage of blood to the sections of the brain that receives blood from the artery. This infarction, has an impact on the functioning of the respiratory system and blood circulation. Consequently, this results in the Wallenberg Syndrome, also known as the lateral medullary syndrome or pica artery syndrome. A consequence of this condition is eventual vell death in certain tissues. This in turn develops certain conditions or symptoms including possible lack of sensations either in the face or in the chin. Individuals with the condition may end up without feeling pain or may feel lesser pain in the chin and face.

Other tell-tale symptoms are associated with the condition including possible vertigo, development of hiccups, and possible nausea. The patient may also experience dysphagia and may have difficulty in walking properly in a balanced manner. Various treatment options for the condition includes speech therapy and swallowing therapy, and in complicated cases patients are fed through a feeding tube. This is because of the inability of the patient to swallow food. Other treatment options include use of blood thinners; for instance, warfarin or heparin.

Individuals at risk of developing the condition

While posterior inferior cerebellar artery is a reason for the syndrome, there are other possible conditions that could cause the syndrome. Individuals who belong to the high-risk category include those with a history of artery disease or other heart ailments. Similarly, patients with a history of frequent blood clot formation, and issues in the neck are also exposed to higher risk. This could be due to certain actions that involve frequent rotation of the neck, and is generally seen in individuals below 45 years of age.

Details of symptoms associated with the condition  

Symptoms that occur due to occlusion and blockage of the artery that delivers blood to the brain stem are as listed below. These symptoms are mainly due to the impact on the functions of the brain stem to facilitate messages to the spinal cord. Additionally, various sensory functions are related to the brain stem and any impact on the stem affects the sensory functions as well. For instance, this could affect the functioning of the muscles and the ability of the individual to experience sensations. Individuals with the condition are more commonly known to suffer from difficulty in swallowing food, a condition medically known as dysphagia. This could then pose indirect problems due to the lack of adequate nutritional intake.

Other commonly reported symptoms of Wallenberg syndrome include a hoarse voice. Patients may frequently experience feelings of nausea, while some are known to have vomiting sensations. Hiccups may develop among patients. Another condition that is easily discernible is nystagmus, referring to abnormal movement of the eyes, wherein the eyes move rapidly, either from side to side, or up and down or the eyes may also move in a circular fashion.

The individual may also feel a sudden reduction in normal sweating, apart from the ability to sense changes in body temperature.  These symptoms should be used to narrow down the diagnosis or the possible reasons, and suitable remedial measures may be initiated. The patient may experience dizzy feelings, and may have difficulty in maintaining balance while walking or coordinating other movements. The posture may appear slightly tilted to one side, appearing to tip over or slant. Other typical symptoms of Wallenberg syndrome include possible numbness on one side of the body. This one side numb feelings could be experienced either in the face, or on the tongue, or it could also be felt in the limbs. Individuals may also experience heat and cold in a manner that is different from that of others.

Wallenberg syndrome is also known to cause bradycardia, a condition that refers to a reduced heart beat rate. Additionally, the patient may also end up with low blood pressure or a spike in blood pressure levels.

Diagnostics for the condition

Diagnosis for the condition include in-depth review of medical history of patient, in addition to tests including a CT scan/MRI. The purpose of these imaging diagnostics is to determine the presence of block in the artery, close to the lateral medulla.

Treatment for the condition

Presently, there is no known cure for the condition; however various therapies are usually recommended to manage conditions symptomatically. For instance, speech therapy, swallowing therapy, use of a feeding tube, pain medication, blood thinners, anti-epileptic medications, and antiseizure drugs are recommended. Surgery is also an option for cases that are considered as extreme.

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