A 52-year-old man with hypertension presents 2 hours after acute onset of right facial weakness and left-sided hemiparesis. Vital signs: BP 168/94 mmHg, HR 88, RR 16, temp 37°C, SpO2 98%. Neurologic exam reveals right facial droop, left arm/leg weakness, and ipsilateral loss of pain and temperature sensation over the right face. CT head shows acute right brainstem infarct. He denies vertigo or ataxia. Which brainstem structure is damaged?
- A)Mid-pons with abducens nerve and corticospinal tract
- B)Upper medulla with hypoglossal nucleus and pyramids
- C)Midbrain with oculomotor nerve and corticospinal tract
- D)Lateral medulla with spinal trigeminal nucleus and spinothalamic tractGABARITO
- E)Medial medulla with corticospinal tract and CN VII
Explicação
Lateral medullary (Wallenberg) syndrome presents with ipsilateral facial pain/temperature loss (spinal trigeminal nucleus), ipsilateral facial weakness (CN VII nucleus), and contralateral body pain/temperature loss (spinothalamic tract). The facial findings ar... Ver explicação completa e trilha adaptativa →