How to diagnose Lateral Medullary Syndrome? - A Case Report
Case Report
M.E. 61-year-old man admitted to emergency department with sudden onset of headache that lasted for 2 h. The patient's blood pressure, heart rate, respiratory rate, SpO2 and body temperature were 140/70 mm/Hg, 92 beats/min, 16/min, 96% and 36°C, respectively.

In his medical history, he had essential hypertension for 10 years and right hemicranial headache. In his physical examination; Horner's syndrome, hemiparesis (4/5 level of muscle strength), increased DTR, Babinski reflex positive, dysmetria, dysdiadochokinesia on the right side and ataxia were present. In observation period in emergency department, he started to have hiccups.

In the laboratory tests: white blood cells were 8000, hemoglobin was 13.0, hematocrit was 37.5, mean corpuscular volume was 84.1, plasma glucose was 142.5, blood urea was 35.2, plasma creatinine was 0.85. AST, ALT, Na, K and CI were 15, 14.5, 142, 5.23 and 103.2, respectively.

The patient's brain CT and diffusion MR images were interpreted (or diagnosed) as normal. He was then hospitalized to the neurology department. Magnetic resonance imaging of the brain, the right side of the medulla oblongata in the brain stem at the level of the FLAIR sequence was interpreted as signaling a high view