Brainstem

Question 1

Fill in: cranial nerve fallout is _ to brainstem lesion

Answer 1

Ipsilateral

Question 2

Fill in : long tract signs are _ to brainstem lesion

Answer 2

Contralateral

Question 3

Fill in: lateral brainsten lesions have _ _ fallout

Answer 3

Contralateral sensory (spinothalamic)

Question 4

Fill in: medial brainstem lesions have _ _ fallout.

Answer 4

Contralateral motor (corticospinal)

Question 5

Which tracts run on the lateral aspect of the brainstem? (3)

Answer 5

Spinothalamic
Sympathetic
Sensory CN nuclei

Question 6

Which tracts run on the medial aspect of the brainstem? (2)

Answer 6

Corticospinal

Motor CN nuclei

Question 7

What is Wallenberg’s syndrome?

Answer 7

Lateral medullary stroke of PICA. Most common brainstem stroke

Question 8

How does wallenburg syndrome / lat medulla stroke present? (7)

Answer 8

Cerebellar peduncle: ipsilat ataxia, nystagmus
Sympa fibres: ipsilat Horner’s syndrome
Spinothalamic fibres: contralat sensory loss pain and temp
CN V sensory desc tract: ipsilat facial numb
CN ix /X: hoarse voice, dysarthria, dysphagia, ipsilat CNIX X paralysis
CN VIII / peduncle: vertigo, nausea, vomit
Vertical diplopia ( skew deviation)

Question 9

If UMN hemi/ tetra paresis, where is brainstem infarct?

Answer 9

Corticospinal tracts

Question 10

What is gaze palsy

Answer 10

Can be horizontal (most common) or vertical
Conjugate gaze palsy: can’t move together
Frequent movement of head instead of eyes

Question 11

Cause of gaze palsy

Answer 11

Brainstem lesion due to stroke