[N2K]Brainstem syndromes

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[N2K]Brainstem syndromes
2010-05-17 15:40:19
brainstem stroke syndromes

brainstem strokes
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  1. Medial medullary syndrome
    • R: medial medulla
    • V: paramedian branches vertebral and anterior spinal a.
    • A: pyramidal tract, medial lemniscus, hypoglossal nucleus
    • C: contralateral arm/leg weakness, contralaterla decreased position and vibration sense, ipsilateral tongue weakness
  2. Wallenberg syndrome
    • R: lateral medulla
    • V: vetebral a. or PICA
    • A/C:
    • Inferior cerebellar peduncle/vestibular neuclei: ipsi ataxia, vertigo, nystagmus, nausea
    • Trigeminal nucleus/tract: ipsi decreased sensation to face (pain, temp)
    • Spinothalamic tract: contra decreased pain,temp body
    • Descending sympathetic fibers: ipsi Horner syndrome (ptosis, miosis, anhydrosis)
    • Nucleus ambiguous: hoarseness, dysphagia
  3. Medial pontine basis only (pure motor hemiparesis)
    • V: paramedian basilar a.
    • A: corticospinal and corticobulbar tracts
    • C: contra face, arm, leg weakness and dysarthria
  4. Millard-Gubler syndrome
    • R: medial pontine basis, tegmentum
    • V: paramedian basilar a. (ventral+dorsal)
    • A: corticospinal/bulbar tract, fascicles facial n.
    • C: contra arm/leg weakness, ipsi face weakness
  5. AICA syndrome
    • R: lateral caudal pons
    • A: middle cerebellar peduncle, spinothalamic tract
    • C: ipsi ataxia, contra decreased body pain, temp
  6. SCA syndrome
    • R: dorsolateral rostral pons
    • A: superior cerebellar peduncle and cerebellum, lateral tegmental structures
    • C: ipsi ataxia, variable features lateral tegmental involvement
  7. Weber syndrome
    • R: midbrain basis
    • V: PCA/basilar a.
    • A: oculomotor nerve, corticospinal tract, cerebellar peduncle
    • C: ipsi CN III palsy, contra HP
  8. Benedikt syndrome
    • R: midbrain basis, tegmentum
    • V: PCA/basilar a.
    • A: oculomotor nerve, cerebral peduncle, red nucleus, substantia nigra, superior cerebellar peduncle
    • C: ipsi III palsy, contra HP, contra ataxia, tremor, involuntary mvmt
  9. Claude syndrome
    • R: midbrain tegmentum
    • V: PCA/basilar a.
    • A: oculomotor nerve, red nucleus, superior cerebellar peduncle
    • C: ipsi III palsy, contra ataxia
  10. Dejerine-Roussy syndrome
    • R: Thalamus
    • V: PCA
    • A: thalamic nuclei
    • C: contra hemisensory loss, contra hemibody pain
  11. Anton syndrome
    • R: occipital cortex
    • V: PCA (bilat) or top basilar a.
    • A: primary visual cortex
    • C: cortical blindness, anosognosia
  12. Alexia without agraphia
    • R: Occipital cortex
    • V: PCA
    • A: optic pathway
    • C: able to write, unable to read
  13. Locked-in syndrome
    • R: ventral pons bilat
    • V: basilar a.
    • A: Corticospinal/corticobulbar tracts; bilat CN VI fasicles
    • C: tetraplegia, lat gaze weakness, bilat facial weakness, dysarthria