A case of bilateral medial medullary infarction presenting with isolated vertigo as the initial symptom
Chen Xiang
Liu Dongwei
Abstract：Medullary infarction is a rare type of stroke with lateral medullary syndrome(Wallenberg syndrome)being the most common condition.While medial medullary infarction on one side is relatively rare,bilateral medial medullary infarction(BMMI)is extremely uncommon in clinical practice.Isolated vertigo is predominantly caused by a peripheral vestibular system lesion,with fewer cases involving the central vestibular system.This article reported a case of acute progressive medullary infarction initially presenting with isolated vertigo,which rapidly progressed to show classic manifestations of medullary infarction,including quadriplegia and dysphagia(coughing while drinking water)within 9 hours.The patient received early aggressive antiplatelet and anticoagulation therapy during the acute phase,followed by secondary prevention measures.At follow-up 3.5 years after onset,the patient ultimately achieved full functional independence,with a modified Rankin scale(mRS)score of 1.This case promotes early MRI in patients with isolated dizziness to screen for BMMI and posterior circulation ischemia,and facilitate timely diagnosis.It also underscores the critical importance of secondary prevention in improving outcomes.By detailing these aspects,we aim to enhance clinicians'awareness of this rare condition and provide valuable references for its diagnosis and management.
Keywords：Isolated vertigoBilateral medial medullary infarctionProgressive strokeSecondary preventionFollow-up
Publication Date：2025-12-18
Online Publishing Date：2025-12-29(First online date of this platform, not the publication date of the document)
Pages：5( 854-858 )