A 60-year-old man presents with complaint of inability to swallow and hoarseness of his voice for the last two hours. His wife tells you about multiple episodes of vomiting and dizziness her husband experienced while moving about the house.His vitals are stable. On clinical examination, you find that he has an ataxic gait towards the left along with miosis and ptosis on the same side. A detailed CNS examination reveals decreased pain, temperature sensations on the right side of his body coupled with a right-sided detion of his uvula. Which of the following aeries has most likely been occluded?
Correct Answer: Posterior Inferior Cerebellar Aery
Description: * Inability to swallow implies that 12th Nerve is involved. (may be IXth Nerve also) * Hoarseness of voice is related to 10th nerve. * Ataxic gait implies involvement of cerebellum. (Post circulation involvement) * Loss of pain & temperature in 1 side means Lat. spinothalamus tract also involved. * Right sided detion of uvula: Vagus involved i.e Left vagus involved. Diagnosis: PICA induced/Wallenberg syndrome/Lat. medullary syndrome ("on one side of face all sensations are lost while on one side of body only pain and temperature are lost") Option A- Involvement of 5,6,7 as it involves PONS Option B- Involvement of CN 3 as it causes MIDBRAIN STROKE Option D- Lenticulostriate Aery- Hemiplegia is caused
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