This question is tricky. I used to always miss this presentation. This is laterally medullary syndrome- which most of us have memorizes is a PICA infarct. Fun fact, PICA comes off the vertebral artery.
This is how I remember the sx. If this helps at least one person I will be glad I am exposing my twisted brain.
3+5=8 & 9-11 & B-P.
3: Horner's syndrome 5:spinal trigeminal- ipsi face pain and temp loss 8: vestibular signs, vertigo diplopia
9-11: Nucleus ambiguous, diminshed gag, dysphagia B: Cerebellar - inferior cerebellar peduncle, ipsi ataxia P: Contra pain and temp, cuz this shit was so painful to memorize I throw it to the other side.
Clinical picture sounds a lot like Wallenberg syndrome, which is classically due to posterior inferior cerebellar artery involvement leading to lateral medullary ischemia.
HOWEVER, vertebral artery dissection is another cause of Wallenberg syndrome and was also covered in one of the UWORLD questions with a similar presentation.
From. the man, the myth, the legend - Dr. Ryan https://d1yboe6750e2cu.cloudfront.net/i/e9f7093da7ea75eafd19ab63669f9fc07d868e14 https://d1yboe6750e2cu.cloudfront.net/i/1e7ee9f42ffdeddfc37e0384006bf153c1a5788c