The hemimedullary syndrome: case report and review of the literature

Mossuto-Agatiello, Luigi; Kniahynicki, C

doi:10.1007/bf00314596

Cited by 22 publications

(11 citation statements)

References 18 publications

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“…The hemodynamic extremely rare simultaneous infarction of all these arteries leads to the hemimedullary syndrome. Only few welldocumented clinical cases have been published [2,10,11]. Interestingly, the description by Reinhold was published one year prior to Wallenberg's description of the most common lateral medulla oblongata infarction syndrome [14], and 20 years prior to Dejerine's description of the less common medial medullary infarction [6], which is, however, considerably more common than a hemimedullary lesion.…”

Section: Discussionmentioning

confidence: 94%

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Babinski-Nageotte’s syndrome and Hemimedullary (Reinhold’s) syndrome are clinically and morphologically distinct conditions

et al. 2003

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A hemimedullary infarction, in which medial and lateral medullary lesions occur simultaneously, is a rare cerebrovascular disease. It has been suggested that the Babinski-Nageotte's syndrome is the classical brainstem syndrome that corresponds to hemimedullary lesion. In this study we compare clinical symptoms and magnetic resonance imaging (MRI) data of two patients exhibiting classical Babinski-Nageotte's syndrome according to the original description with symptoms and MRI data of a patient with clinically complete hemimedullary lesion. Our study shows that Babinski-Nageotte's syndrome is neither clinically nor on MRI identical with hemimedullary lesion. Hypoglossal palsy, an invariable symptom of hemimedullary syndrome, is not part of the Babinski-Nageotte's syndrome according to the original description. Consistent with the original historical report, Babinski- Nageotte's syndrome is a lateral "Wallenbergian" medullary lesion with a spreading of the lesion to the more basal localised pyramidal tract. The clinical features of the hemimedullary syndrome, described in 1894 by Reinhold, and the MRI appearances in our patient with this syndrome are clearly different from other classical brainstem syndromes and should be called Reinhold's syndrome.

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Section: Discussionmentioning

confidence: 94%

“…All patients in these recent publications had ipsilateral peripheral hypoglossus paresis (tongue weakness). The peripheral hypoglossus paralysis is an obligate symptom of the medial medullary Dejerine's syndrome [6] as well as of hemimedullary infarction [10,13], but it is not a symptom of Babinski-Nageotte's syndrome [1].…”

Section: Discussionmentioning

confidence: 99%

Babinski-Nageotte’s syndrome and Hemimedullary (Reinhold’s) syndrome are clinically and morphologically distinct conditions

et al. 2003

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“…Hemimedullary syndrome is an uncommon disease. About 10 patients with this syndrome have been previously reported [9,10,13]. In comparison with these three syndromes of the medulla oblongata, the Babinski-Nageotte [1] and CestanChenais [3] syndromes are much less familiar cerebrovascular diseases.…”

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confidence: 97%

Between Wallenberg syndrome and hemimedullary lesion

et al. 2006

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In comparison with the lateral (Wallenberg), medial (Dejerine) and hemimedullary (Reinhold) medulla oblongata syndromes, the Babinski-Nageotte and Cestan-Chenais syndromes are much less familiar cerebrovascular disorders. While the Babinski-Nageotte syndrome is usually confused with the hemimedullary syndrome, reports of the extremely rare Cestan-Chenais syndrome are missing from the modern neurological literature. The pathological and magnetic resonance imaging (MRI) correlations of the Cestan-Chenais syndrome have not been shown so far. We compared clinical and MRI features of two patients exhibiting classical Babinski-Nageotte and Cestan-Chenais syndromes according to their original descriptions with those of three patients with lateral, medial and hemimedullary syndromes. Our study shows that Babinski-Nageotte syndrome includes all symptoms of the Wallenberg syndrome and additionally contralateral hemiparesis due to a spreading of the "Wallenbergian" lateral lesion to the pyramidal tract. The Cestan-Chenais syndrome includes all symptoms of the Babinski-Nageotte syndrome with the exception of the ipsilateral cerebellary hemiataxia because of sparing of the posterior spinocerebellar tract. The Babinski-Nageotte syndrome is neither clinically nor on MRI identical with hemimedullary syndrome. Hypoglossal palsy, an invariable symptom of hemimedullary lesion is not part of the Babinski-Nageotte syndrome. The contralateral hypesthesia is dissociated in the Babinski-Nageotte syndrome. The Babinski-Nageotte and Cestan-Chenais syndromes are intermediolateral medullary syndromes with all (Babinski-Nageotte) or nearly all (Cestan-Chenais) features of the lateral and some features of the medial medulla oblongata syndromes.

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“…Diffusionweighted imaging revealed a hyperintense lesion in the right dorsolateral medulla oblongata and FLAIR imaging showed a hyperintense lesion in the right medial and lateral medulla oblongata with extension of the lesion in the cervicomedullary junction Dear Sir, Hemimedullary syndrome has been introduced as Babinski-Nageotte syndrome or Reinhold syndrome with ischemic lesion in unilateral lateral and medial medulla oblongata [1][2][3] . The identity of hemimedullary stroke has remained controversial because both medial and lateral medullary infarctions rarely occur simultaneously and vascular supplies of the medial and lateral medulla usually differ [4,5] .…”

Section: Hemimedullary Syndrome With Ipsilateral Sensorimotor Defi Citsmentioning

confidence: 99%