Block 3 Flashcards
Basilar artery infarct
Affects medial pons.
Causes medial pontine syndrome:
Loss of CST, DCML, CN VI.
CST - Contralateral hemiplegia, body.
DCML - Contralateral loss of tactile sensation.
CN VI - Gaze palsy (inactive lateral rectus muscles).
PCA infarct, with medial damage only
Affects midbrain.
Causes Benedikt’s syndrome:
Loss of CN III, SN.
CN III - Ipsilateral CN III palsy.
SN - Contralateral Parkinsonism.
*Compared to Weber’s, no hemiplegia of body (CST is spared). There is ataxia though.
PCA infarct
Affects midbrain.
Causes Weber’s syndrome:
Loss of CN III, SN, CST, CBT.
CN III - Ipsilateral CN III palsy.
SN - Contralateral Parkinsonism.
CST - Contralateral hemiplegia of body.
CBT - Contralateral hemiplegia of face.
AICA infarct
or superior cerebellar artery
Affects lateral pons.
Causes lateral pontine syndrome:
Loss of STT, CN V, CN VII, CN VIII, Cochlear nucleus, MCP, ICP, sympathetic tract.
STT - Contralateral loss of pain/temp.
CN V - Ipsilateral loss of pain/temp of face.
CN VII - Ipsilateral loss of facial motor control, lacrimation, taste (ant 2/3).
CN VIII - nystagmus, nausea, vomiting, vertigo.
Cochlear nuclei - ipsilateral loss of hearing.
MCP, ICP - Ipsilateral gait ataxia.
Sympathetic tract - Ipsilateral Horner’s.
Anterior spinal artery infarct
or vertebral artery
Affects medial medulla.
Causes medial medullary syndrome:
Loss of CN XII, CST, DCML.
CN XII - Ipsilateral tongue paralysis.
CST - Contralateral hemiplegia of body.
DCML - Contralateral loss of tactile sensation.
*Note the “alternating hemiplegia”.
PICA infarct
or vertebral artery
Affects lateral medulla.
Causes lateral medullary syndrome,
aka Wallenberg syndrome:
Loss of STT, CN V, CN VII, CN X, CN XII, ICP.
STT - Contralateral loss of pain/temp.
CN VIII - nystagmus, nausea, vomiting, vertigo.
ICP - Ipsilateral ataxia, dysdiadochokinesis.
CN V - Ipsilateral loss of pain/temp of face.
CN X - Diminished gag reflex.
CN XII - Ipsilateral paralysis of pharynx and larynx.
