Saloni Gupta;
David Geffen School of Medicine at UCLA
Omid Jafari;
Olive View-UCLA Medical Center
Ryan Beck;
Olive View-UCLA Medical Center
Catherine Yim;
Olive View-UCLA Medical Center
Mariam Thomas;
Olive View-UCLA Medical Center
Gasser Hathout;
Olive View-UCLA Medical Center
Background
The medulla oblongata, also known as the myelencephalon, is the most caudal portion of the brainstem. The medulla is a crucial part of neuroanatomy and is responsible for many primitive functions, including cardiovascular, respiratory, and autonomic regulation. The medulla also holds several cranial nerve nuclei and motor and sensory tracts. Because proper functioning of the medulla is so important for survival and quality of life, it is extremely important that radiologists be aware of not only the normal anatomy of the medulla, but also various pathologies that can affect it. Knowing how discrete patient signs and symptoms correlate with specific areas within the medulla can aid radiologists in localizing pathology on imaging. The aim of this presentation is to provide a review of the anatomy and imaging of different parts of the medulla and correlate imaging findings with patients’ clinical presentation.
Educational Goals / Teaching Points
Review the anatomical structures in the medulla oblongata with imaging correlation. Review the function of specific areas within the medulla. Review a variety of clinical disorders that can affect the medulla in correlation with their clinical features and imaging findings.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The medulla is a complex structure that can have various associated pathologic processes. Because of this complexity, medullary lesions can present with a vast array of clinical signs and symptoms. This variety can make it difficult for radiologists to localize lesions or know which areas to focus on when reading images. This presentation will highlight the detailed anatomy and corresponding functions of various parts of the medulla. This will be followed by a case-based review of lesions in various parts of the medulla, with imaging findings shown on CT and MRI. Pathologies covered will include various stroke syndromes such as Wallenberg syndrome, Dejerine’s syndrome, and Babinski-Nageotte syndrome along with infections, tumors, degenerative processes, hypertrophic olivary degeneration and olivopontocerebellar atrophy, demyelinating processes, and toxic and metabolic processes. Special attention will be given to patients’ clinical symptoms in each case aiding the audience in knowing how to correlate each patient’s clinical picture with their disease.
Conclusion
The medulla is a critical portion of the brainstem with essential functions. With proper knowledge of its anatomy and pathologies that affect the indwelling structures, radiologists will be equipped to diagnose lesions in this region.
