The Wallenberg-Zakharchenko syndrome is named after scientists who almost simultaneously and independently of each other described this brain damage. It refers to a group of alternating syndromes associated with impaired blood flow to the brain.
The cause of development of Wallenberg syndrome is an insult-like thrombosis of the posterior artery, supplying the blood to the cerebellum.
As a rule, loss of consciousness does not happen, but there is a sharp dizziness, lack of balance, there may be hiccup or vomiting and slight deafness.
The factor that causes thrombosis is atherosclerosis of the vessels, as well as endarteritis of the artery of the syphilitic spine, or the posterior lower cerebellar line lagging behind it, or rheumvasculitis.
Thrombotic or non-thrombotic lesion mainly occurs slowly. The most common lesions of the vertebral and basilar arteries. In this case, the symptoms of the syndrome alternate with periods of improvement and deterioration, however, the disease itself is gradually progressing.
Options for the manifestation of the
syndrome Doctors distinguish five variants of the development of the Wallenberg-Zakharchenko syndrome, which differ in the specificity of the localization of the pathology center and, accordingly, with clinical indications.
The main type of
syndrome The main type is characterized by:
- paralysis of the muscles of the soft palate and vocal cords;
- by cerebellar hemiataxy;
- by Horner's syndrome;
- dissociated disruption of sensation of surfaces located mainly in the middle and caudal zones of the Zelder.
Rarer types of development of
Affected areas are indicated by
points. The syndrome can also manifest itself in such forms:
- Type, , the capturing lower portions of the variola bridge due to increased retreat of the posterior lower cerebellar artery. In this variant, in addition to the above characteristics, additional ones are observed, which are divided into two groups: related to the inferiority of the sixth nerve;determined by the inferiority of the seventh nerve.
- Type, observed when included in the destructive process of the tail sections in the medulla oblongata , determined by the reducing retreat of the cerebellar artery. Ipsilateral syndromes will be the same as the original type. In the contralateral, triplegia or cross hemiplegia appears.
- The type for which the is characterized by the affected center of the spinal cord of the trigeminal nerve and its spine .Also, the conductive paths responsible for the superficial sensitivity of the opposite part of the face can also be violated. The ipsilateral characteristics of this variant differ from the first one by the absence of discordant changes in the upper sensitivity on parts of the face belonging to the Zelder zone. The peculiarity of contralateral manifestations is manifested in the possibility of a person's grasping hemihyesthesia by surface susceptibility.
- In the latter type of , the lesion is dilated by the inclusion of the surface susceptibility conductors responsible for the second side of the face. Its signs are similar to the first type, only more extended.
Clinical manifestations and therapy
Clinic of Wallenberg's syndrome Zakharchenko is diverse, but its main symptoms are quite typical:
- swallowing disorder;
- speech disorder;
- is not the activity of a part of the soft palate;
- real estate of the voice ligament;
- manifestation of Horner's syndrome;
- appearance of vestibular-cerebellar signs( empty hand and foot movements, nystagmus, tremor, lack of balance);
- no temperature or pain sensations on the opposite side to the lesion;
- occurrence of headaches on the side of the lesion or all over the face.
This clinical manifestation is caused by the overlapping of the posterior inferior cerebellar artery, which leads to the extinction of the outer parts of the medulla oblongata, the location of the trigeminal nerve, namely its descending and ascending bundles, sympathetic fibers.
If you have symptoms, you need to take action as soon as possible. Treatment should be carried out in the first hours after the onset of Wallenberg's syndrome, it will consist in stabilizing the vital functions of the brain and removing the swelling of the tissues.
The earlier the help was rendered, the less tissue damage and, consequently, the recovery process will be easier. If the help has not been for a long time, the changes can become irreversible, which leads to disability of the person.
If breathing is disturbed, oxygen therapy is performed using a mask or artificial respiration under the device. It is also necessary to maintain the mode of cardiac activity and the level of blood pressure is normal, since Wallenberg-Zakharchenko syndrome is a consequence of increased pressure, so the patient is given the means that reduce it.
They are supplemented with cardiac glycosides and nitrates. Mandatory in the first hours is the normalization of blood clotting and its density.
Neuroprotectors are used to protect brain cells. Symptomatic drugs for pain relief, muscle relaxation, soothing and anticonvulsants may also be prescribed.
