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Medial Medullary Infarction

A 62 year-old man presented with a left hemiparesis sparing the face, along with a right hypoglossal (cranial nerve XII) palsy. Sensation was intact.

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Medial Medullary Infarction: Diffusion-weighted MRI scans; (Left) Lower medulla; (Right) Upper medulla. Note the small area of infarction (bright signal) in the right medial medulla. Infarcts in the medial medulla result in a classic "crossed" neurological syndrome of an ipsilateral hypoglossal nerve palsy with a contralateral hemiparesis. This is an uncommon lesion. The medial medulla is typically supplied by a branch of the anterior spinal artery which arises from the vertebral arteries. 

Revised 11/30/06
Copyrighted 2006. David C Preston