Lateral Medullary Syndrome Due to Left Vertebral Artery Occlusion in a BoyPostflexion Neck Injury

摘要

Lateral medullary syndrome is rare in pediatrics. It is characterized by neurologicaldeficits due to an ischemic lesion in the lateral medulla. The authors describe a17-year-old boy who developed lateral medullary syndrome in the context of a hyperflexionneck injury while diving in shallow water with traumatic vascular injury. He had “crossed”neurological deficits above and below the neck. His magnetic resonance angiography showedintra- and extracranial left vertebral artery occlusion and his magnetic resonance imagingshowed signal abnormality involving the left lateral medulla and inferomedial cerebellumin keeping with an infarct secondary to left vertebral artery and left posterior inferiorcerebellar artery occlusion. Good neurological recovery was observed on heparin therapystarted after surgical treatment of traumatic injury. To our knowledge, this is the firstreported case of lateral medullary syndrome in a pediatric population related to a flexionneck injury. The authors emphasize the importance of a high level of suspicion foraccurate diagnosis.