Pica syndrome nystagmus9/20/2023 ![]() The tonsillomedullary segment begins where the PICA passes posterior to the CN IX-XI and ends at the midpoint of the PICA's ascent toward the roof of the fourth ventricle along the medial surface of the tonsil.The lateral medullary segment extends from the level of the most prominent point of the olive to the level of the origin of the glossopharyngeal (CN IX), vagus (CN X), and accessory (CN XI) rootlets.It ends at the level of a rostrocaudal line that passes through the most prominent part of the inferior olive. The anterior medullary segment begins at the origin of the PICA.The trunk of PICA is divided into five segments: The fourth segment of the vertebral artery gives off the PICA, the largest branch of the vertebral artery. ![]() The vertebral artery, arising from the subclavian artery, is classically divided into four segments. The posterior inferior cerebellar artery (PICA) usually originates from the vertebral artery at an average distance of approximately 16 or 17 mm below the vertebrobasilar junction. This neurological disorder is associated with various symptoms that result from damage to the lateral segment of the medulla posterior to the inferior olivary nucleus. Wallenberg syndrome is also called lateral medullary or posterior inferior cerebellar artery syndrome. However, a more detailed description given in 1895 by Adolf Wallenberg identified this condition as infarction of the lateral medulla oblongata following occlusion of the vertebral artery (VA) or Posterior inferior cerebellar artery (PICA). Wallenberg syndrome was first described in 1808 by Gaspard Vieusseux.
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