[Crossed pattern of sensory loss with left thoracic level in a right dorsolateral medullary infarction].

INTRODUCTION: Medullary infarctions as consequence of vertebro-basilar strokes are frequent findings in clinical practice. Medulla oblongata, the lowest segment of the brainstem, is a dense anatomic structure with different conglomerate of nuclei, ascending and descending pathways within a very small area and tiny insults can present with expressive clinical manifestations. Sensory dysfunction is often a noteworthy element in lateral medullary infarctions and its distribution depends of the site and shape of the lesion within the medulla oblongata. From etiological point of view the most frequent cause of lateral medullary infarctions is atherosclerosis although vertebral dissection has to be carefully ruled out.

CASE REPORT: A 65 year-old man with a left pain and temperature sensory level up to T4 in a right lateral medullary infarctions due to ipsilateral PICA territory infarction. Crossed pattern of sensory loss with a sensory level is a quite unusual presentation of lateral medullary infarctions and expresses the involvement of the most external aspect of the spinothalamic tract.