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NBME 22 Answers

nbme22/Block 2/Question#38

Following a stroke, a patient is hoarse and cannot ...

Lateral medulla

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submitted by moloko270(31),

this is Wallenberg syndrome - stroke caused by obstruction of PICA - so thats why we get symptoms of dysphagia, hoarseness, absent gag reflex (p. 502 FA)

armymed88  dysphagia from hit of nucleus ambiguus (CN IX/X/XI) Sensation changes due to hit of lateral spinothalamic tract and spinal trigeminal Check out rule of 4s if you haven't already +  
theecohummer  Yup, lateral meduallary syndrome or Wallenburg Syndrome. Whatever you want to call it. The hemifacial analgesia is from damage to the spinal trigeminal nucleus/tract, and you get the hoarseness from damage to the vagus and the body loss is from the spinal thalamic tract. You can also get Horner’s syndrome with this. +1  
dr.xx  Lateral medullary syndrome = Wallenberg's syndrome +