Injury of the lateral vestibulospinal tract in a patient with the lateral medullary syndrome: Case report.

RATIONALE Lateral medullary syndrome is a central vestibular disorder characterized by vertigo and ataxia. We report on a patient with injury of the lateral vestibulospinal tract (VST) following lateral medullary syndrome, detected on diffusion tensor tractography (DTT). PATIENT CONCERNS A 56-year-old male patient was diagnosed with lateral medullary syndrome due to an infarction in the posterior inferior cerebellar artery area. DIAGNOSES Two weeks following the infarction, he was transferred to the rehabilitation department of the same university hospital with severe vertigo, ataxia (Berg balance scale: 16 point), and dysphasia. In contrast, he maintained good motor power and cognitive function (Mini-mental state test: 26 points). INTERVENTIONS N/A OUTCOMES:: Both the patient's medial VSTs and left lateral VST were well-reconstructed. In contrast, the right lateral VST was not reconstructed. On DTT parameters of the VST, the patient's medial VSTs and left lateral VST did not differ significantly from the control subjects. LESSONS An injury of the right lateral VST was demonstrated in a patient with lateral medullary syndrome. We believe that the result will be helpful in clinical management and research for patients with lateral medullary syndrome.