Exciting neurology pathophysiology question

[Pantaloons]

Hey guys, I have a question about Medial medullary syndrome vs. complete occlusion of the anterior spinal artery. I don't understand their presentations.

 

I'm also a noob clerk and I know it's summer, but indulge me.

 

In Medial Medullary Syndrome, you have a lesion to the Anterior Spinal Artery. This results in infarction to the medial medulla oblongata.

Presentation:

- Contralateral hemoparesis -- due to Corticospinal tract damage

- Contralateral proprioception loss -- due to medial lemniscus damage

- Ipsilateral tongue paralysis -- due to damage to hypoglossal nerve

 

In Complete Occlusion of the anterior spinal artery, you have infarction of everything in the spinal cord except for the dorsal columns (and the Lissauer's tract)

 

I am confused:

The Dorsal Columns ascend and decussate to become the medial lemniscus. So, could Complete occlusion of the Anterior spinal artery present similarly as Medial Medullary Syndrome? Is the occlusion just one possible cause of "medial medullary syndrome", or are they separate entities?

Could you see Ipsilateral tongue paralysis with Complete occlusion of the anterior spinal, or would collateral circulation come into play?

 

Why is neurology so nuts?

 

derpderp,

- Pantaloons

[leviathan]

Hey pantaloons,

 

I remember that confusing me back in neuro too, and you think someone would have bothered to make this clear to avoid confusion eh? Anyway, it depends on the level of the lesion of the anterior spinal artery, whether it is at the medullary level or spinal cord level.