Infarction of the medulla and cervical cord after fitness exercises.

The clinical association of a left lateral medullary syndrome with left corticospinal and posterior column deficits is reported in the case of a young woman with a left vertebral artery dissection. The signs are explicable on the basis of occlusion of branches of the vertebral artery to both the upper cervical cord and the medulla. The dissection may have been due to sustained rotation of the neck during fitness classes. In view of the undocumented benefits and the potential unwanted effects of this exercise, it is doubtful whether it should be recommended.