Brainstem Lesions 1 And 2 - 4/25 Stephens Flashcards
What is characterized by the following:
Destruction of the Hypoglossal nerve
Destruction of the ipsilateral LCST
Partial destruction of the contralateral LCST
Alternating Hypoglossal Hemiplegia and destruction of the contralateral LCST
What condition is the following?
Protrusion of the tongue to the right
Loss of proprioception/2pt tactile discrimination on the left (contralaterally)
Alternating Hypoglossal Hemiplegia and destruction of the ipsilateral ML
Alternating Abducent Hemiplegia is a result of what?
Destruction of Abducens nerve and internal strabismus
Destruction of ipsilateral LCST
Millard-Gubler’s Syndrome is what?
Alternating Abducens Hemiplegia
PLUS CN 7 lesion (Bell’s Palsy)
Syndrome of Foville is what?
May also involve what?
What is the reason for this involvement?
A6H + ML
Aka Abducens Hemiplegia + contralateral loss of prop/2pt tactile discrim
Facial nerve, IPSILATERAL nucleus Ambiguus and Hypoglossal nucleus
Destruction of crossed corticobulbar fibers
Alternating Trigeminal Hemiplegia has what deficits?
Destruction of CN 5 -> Ipsilateral loss of sensation from half of the face and scalp, paralysis of ipsilateral muscles of mastication
Destruction of LCST -> contralateral spastic Hemiplegia
Alternating Trigeminal Hemiplegia with a Dorsal Expansion has what characteristics?
What else may be affected due to uncrossed corticobulbar fibers?
A5H with destruction of ML -> contralateral loss of prop/2pt
CONTRALATERAL CN nuclei: Abducens Facial Hypoglossal Nucleus Ambiguus
Weber’s Syndrome is also known as what?
Alternating Oculomotor Hemiplegia
Symptoms involved in A3H?
CN 3 - External strabismus, complete ptosis, pupillary dilation
LCST - contralateral spastic Hemiplegia
SubNigra - Contralateral resting tremor
Uncrossed corticobulbar fibers - Supranuclear facial palsy
What is lesion is characterized by dysphagia, dysarthria, hoarseness, paresis of the ipsilateral palatal muscles
AND
Contralateral loss of pain/temp from the body?
Lesion of Nuc Ambiguus and SL
Lateral Medullary Syndrome/Wallenberg’s syndrome can be described simply how?
Alternating hemianalgesia with dysphagia
What specifically is destroyed in Wallenberg syndrome?
SL - contralateral hemianalgesia
Descending tract of V - loss of pain/temp to the face
CN 9 and 10
Nucleus Ambiguus
What vessel when compromised results in lateral medullary syndrome?
PICA
Cerebellopontine Angle (CPA) Syndrome can be described simply how?
Alternating Hemianalgesia with DEAFNESS
What specifically is destroyed in CPA Syndrome?
CN 8
CN 7
Desc Tract of CN 5
SL
Parniaud’s Syndrome is due to a lesion of what?
Pineal body
Superior colliculus
Great vein of Galen
What is the principal sign of Parinaud’s Syndrome?
What may these lesions destroy?
Paralysis of upward Gaze
Posterior commissure and therefore consensual light reflex
Thalami can Syndrome (Dejerine-Roussy Syndrome) is usually due to what?
Hallmark symptom?
Thrombosis of the posterior choroidal or thalamogeniculate branches of the PCA
Crawling ant sensations
Benedikt’s Syndrome is a lesion of what?
Destructions of what structures?
Midbrain Tegmentum
CN 3
ML
Red nucleus, fibers of Sup. cerebellar peduncle -> intention tremors
Symptoms of Benedikt’s syndrome?
Oculomotor palsy
Contralateral loss of pain/temp AND prop/2pt
Intention tremors
Alternating Hypoglossal Hemiplegia is due to the destruction of what structures?
Symptoms?
Hypoglossal nerve
LCST -> UMN
Atrophy of ipsilateral muscles of the tongue
Contralateral spastic Hemiplegia
