Brain stem lesions pt 2

Question 1

Name the brainstem location and highlighted areas

Answer 1

rostral medulla

RED = motor

yellow = pain/temp

purple = MLF

green = medial lemniscus

Question 2

Name the brainstem location and highlighted areas

Answer 2

Pons at the level of the facial colliculus

RED = motor

yellow = pain/temp

purple = MLF

green = medial lemniscus

Question 3

Name the brainstem location and highlighted areas

Answer 3

CPA

RED = motor

yellow = pain/temp

purple = MLF

green = medial lemniscus

Question 4

Name the brainstem location and highlighted areas

Answer 4

Mid pons @ trigeminal n.

RED = motor

yellow = pain/temp

purple = MLF

green = medial lemniscus

Question 5

Name the brainstem location and highlighted areas

Answer 5

Midbrain @ diencephalon and posterior commissure

RED = motor

yellow = pain/temp

purple = MLF

green = medial lemniscus

Question 6

Name the brainstem location and highlighted areas

Answer 6

Upper medulla and lower pons

RED = motor

yellow = pain/temp

purple = MLF

green = medial lemniscus

Question 7

Name the brainstem location, highlighted areas, and syndrome/condition

Answer 7

Benedikt’s Syndrome (Lesion of the Midbrain Tegmentum)

1) Destruction of the oculomotor nerve: external strabismus, pupillary dilation, complete ptosis.
2) Destruction of the medial lemniscus: contralateral loss of proprioception, 2-point tactile discrimination from body + limbs.
3) Lesions of red nucleus, fibers of superior cerebellar peduncle, midbrain tegmentum: present with ipsilateral oculomotor palsy, and contralateral motor dysfunction such as tremor, ataxia or choreiform movements. The patients may also show varying degrees of spasticity.

Question 8

Name the brainstem location, highlighted areas, and syndrome/condition

Answer 8

Cerebellopontine Angle syndrome

One of the most common tumors of the posterior cranial fossa in adults is the acoustic neurinoma. As the tumor enlarges it compresses the lateral aspect of the pons, cerebellum and medulla.

1. Destruction of the vestibulocochlear nerve results in deafness and vestibular disturbances.
2. Destruction of the facial nerve results in Bell’s palsy.
3. Alternating Hemianalgesia refers to (two things): ipsilateral loss of pain and temperature sensations from the face , contralateral loss of pain/temperature sensations from the body
   3a) Destruction of the descending tract of V results in ipsilateral loss of pain/temperature sensations from the face.
   3b) Destruction of the spinal lemniscus results in contralateral hemianalgesia of the body
4. Involvement of the cerebellar peduncles results in some degree of ipsilateral cerebellar ataxia, intention tremor, dysmetria and dysdiadochokinesia.

Question 9

Name the brainstem location, highlighted areas, and syndrome/condition

Answer 9

Cerebellopontine Angle syndrome

One of the most common tumors of the posterior cranial fossa in adults is the acoustic neurinoma. As the tumor enlarges it compresses the lateral aspect of the pons, cerebellum and medulla.

1. Destruction of the vestibulocochlear nerve results in deafness and vestibular disturbances.
2. Destruction of the facial nerve results in Bell’s palsy.
3. Alternating Hemianalgesia refers to (two things): i_psilateral loss of pain and temperature sensations from the face , contralateral loss of pain/temperature sensations from the body_
   3a) Destruction of the descending tract of V results in ipsilateral loss of pain/temperature sensations from the face.
   3b) Destruction of the spinal lemniscus results in contralateral hemianalgesia of the body
4. Involvement of the cerebellar peduncles results in some degree of ipsilateral cerebellar ataxia, intention tremor, dysmetria and dysdiadochokinesia.

Question 10

1. reduced hearing in r. ear, dizziness, postural issues.
2. paralysis of r. side of face but mastication in tact
3. reduced P/T from r. face
4. reduced P/T from l. side of body
5. intention tremor, reduced coordination
6. ataxia

Answer 10

Cerebellopontine Angle syndrome

One of the most common tumors of the posterior cranial fossa in adults is the acoustic neurinoma. As the tumor enlarges it compresses the lateral aspect of the pons, cerebellum and medulla.

3a) Destruction of the descending tract of V results in ipsilateral loss of pain/temperature sensations from the face.
3b) Destruction of the spinal lemniscus results in contralateral hemianalgesia of the body
4. Involvement of the cerebellar peduncles results in some degree of ipsilateral cerebellar ataxia, intention tremor, dysmetria and dysdiadochokinesia.