回転性めまいを主訴としMRAで病変部位が確認できたWallenberg症候群例

概要

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A 32-year-old woman was admitted for acute vertigo with posterior cervical pain. It was suspected that an inner ear disorder was causing the vertigo because the patient had no neurological symptoms other than left-beating nystagmus and difficulty in standing, and computed tomography (CT) of the brain showed no abnormality. However she was diagnosed as having Wallenberg syndrome, because magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) revealed a vertebral artery dissection, which can cause posterior cervical pain. Although vertigo is often caused by an inner ear disease, a cerebrovascular disease should be considered in the differential diagnosis of vertigo, even in a case of a young adult. In many cases, patients with cerebrovascular disease have some neurological symptoms, but some of them have minimal symptoms, especially at the initial visit. When the diagnosis is uncertain, MRI and MRA are useful.