Although it is well known that
Wallenberg's syndrome is caused by occlusion of the vertebral artery (VA) or the posterior inferior cerebellar artery (
PICA), the etiology of the occlusion is rarely documented. During the course of
Wallenberg's syndrome, patients often complain of
headache. We thought that these
headaches might be caused by
dissecting aneurysm (DA) of the vertebral artery, and so we studied the incidence of DA in our cases with
Wallenberg's syndrome. Although many variants exist,
Wallenberg's syndrome encompasses several neurological symptoms due to a disorder of the nucleus and nerve tracts located in the lateral part of the medulla. We diagnosed our patients as having
Wallenberg's syndrome on the basis of symptoms such as loss of
pain and temperature sensation in the unilateral face and contralateral body,
cerebellar ataxia, and
dysphasia. We investigated 22 cases of
Wallenberg's syndrome over a five-year period, and excluded patients who developed
subarachnoid hemorrhage upon onset of the syndrome. Our cases can be divided into two groups; one with severe
stenosis or occlusion of VA (n = 15) and the other with occlusion of
PICA (n = 5). The angiograms of the two remaining patients showed no abnormal findings. The mean age of the VA group (42.5 yrs.) was younger than that of the
PICA group (64.2 yrs.). The age distribution of the
PICA group is similar to that of other occlusive
cerebrovascular diseases. Seven cases of the VA group demonstrated aneurysmal dilatation and
luminal stenosis, and so they were diagnosed as having
dissecting aneurysm of VA.(ABSTRACT TRUNCATED AT 250 WORDS)