The syndrome can also be due to occlusion of the vertebral artery, or the inferior, middle, or superior medullary vessels. The primary pathology of Wallenberg syndrome is occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches. Large artery atherothrombotic causes account for about 75% of the cases followed by cardioembolism in 17% and vertebral dissection in 8%. There is a predominance of men in their sixth decade. Twenty percent of the ischemic strokes occur in the posterior circulation. If clinicians assume that about half of these suffer from Wallenberg syndrome, it can be estimated that there are more than 60,000 new cases of Wallenberg syndrome each year in the United States.
There are nearly 800,000 patients who suffer from an acute stroke each year in the United States. Wallenberg syndrome is the most prevalent posterior ischemic stroke syndrome. Vertebral artery dissection is the commonest cause of Wallenberg syndrome in younger patients. Cerebral embolism is a less frequent cause of the infarction. The other important cause to remember is vertebral artery dissection, which may have risk factors including neck manipulation or injury, Marfan syndrome, Ehlers Danlos syndrome, and fibromuscular dysplasia. Hypertension is the most prevalent risk factor, followed by smoking and diabetes. Wallenberg syndrome is caused most commonly by atherothrombotic occlusion of the vertebral artery, followed most frequently by the posterior inferior cerebellar artery, and least often, the medullary arteries. When there is decreased blood flow to these regions, patients typically present with signs and symptoms of posterior circulation stroke which are discussed later. PICA supplies the medulla and the suboccipital surface in the part of the cerebellum. The posterior inferior cerebellar artery (PICA) is derived from each vertebral artery. They enter the skull through the foremen magnum and merge to form the basilar artery at the pontomedullary junction. The vertebral arteries arise from the subclavian arteries. It is the most typical posterior circulation ischemic stroke syndrome in clinical practice. This neurological disorder is associated with a variety of symptoms that occur as a result of damage to the lateral segment of the medulla posterior to the inferior olivary nucleus. Wallenberg described the first case in 1895. Wallenberg syndrome is also known as lateral medullary syndrome or the posterior inferior cerebellar artery syndrome. Explain a well-coordinated, interprofessional team approach to provide effective care to patients affected by Wallenberg syndrome.
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