Since the first description of Wallenberg's syndrome more than 100 years ago, clinical and pathological findings of lateral medullary infarction (LMI) have been sporadically reported. Dizziness and ataxia are one of the most common symptoms/signs of lateral medullary infarction (LMI). Other symptoms/signs include nystagmus and ocular motor abnormality, dysphagia, dysarthria, hoarseness, nausea/vomiting, and hiccup. In patients with normal angiographic findings, atherothrombotic occlusion of a perforating artery itself seems to be the mechanism of infarction. Medial medullary infarction is usually caused by occlusion of penetrating branches associated with an atherosclerotic distal vertebral artery (VA) or vertebral arteries-basilar artery (VA-BA) junction. Lateral and medial medullary infarction may occur simultaneously or consecutively. Spontaneous primary medullary hemorrhage is rare. Although the causative role of hypertension is controversial, autopsy and imaging studies illustrate that hypertensive medullary hemorrhage does exist. Cavernous angiomas are a relatively frequent cause of medullary hemorrhage.

Intracerebral hemorrhage (ICH) presents clinically in a variety of ways, depending primarily on the location and size of the hematoma. Several studies have correlated the anatomical location of putaminal hemorrhages with their clinical presentation. Caudate hemorrhage presents with sudden onset of headache, vomiting, and altered level of consciousness, resembling subarachnoid hemorrhage (SAH) from ruptured cerebral aneurysm. Behavioral and neuropsychological abnormalities can be a prominent part of the clinical picture of caudate hemorrhage. Lobar ICHs occur in any of the cerebral lobes, generally favoring the parietal and occipital areas although some series have reported a predominance of frontal or temporal locations. Primary hemorrhage into the medulla oblongata is the least common of all brain hemorrhages. The most consistent clinical profile in medullary hemorrhage has been with sudden onset of headache, vertigo, dysphagia, dysphonia or dysarthria, and limb incoordination.