Brainstem stroke syndromes Flashcards
________ are medial to the sulcus limitans
motor nuclei
________ are lateral to the sulcus limitans
sensory
Stroke of the midbrain tegmentum due to occlusion of PCA perforations
benedikt syndrome
affect the red nucleus and substantia nigra and the fascicular potion of CN III
benedikt syndrome
causes ipsilateral CNIII (oculomotor) palsy and
contralateral involuntary movements
benedikt syndrome
in benedikt syndrome there is hemiplegia if
corticospinal tract is affected
Weber syndrome is due to occlusion of ?
the paramedian branches of the posterior cerebral artery or of basilar bifurcation perforating arteries
What are the 4 damaged structures in weber syndrome?
substantia nigra
corticospinal fibers
corticobulbar tracts
ipsilateral oculomotor nerve palsy
similar to benedikt syndrome but more severe contralateral weakness
weber syndrome
Damage to Substantia nigra casues
Contralateral parkinsonism
damage to corticospinal fibers =?
Contralateral hemiparesis and typical upper motor neuron findings
damage to Corticobulbar tracts
Difficulty with contralateral lower facial muscles and hypoglossal nerve functions
damage to Ipsilateral oculomotor nerve palsy
ad roping eyelid and fixed wide pupil pointed down and out this leads to diplopia
damage to Dentatorubral tract
Contralateral ataxia
More dorsal than benedikt
claudes
affects the red nucleus, dentothalamic nuclei within superior cerebellar peduncle and CNIII fascicles
claudes
Occlusion in claudes syndrome
midbrain infarction as a result of occlusion of a branch of the posterior cerebral artery
What are the 4 damaged structures in claudes syndrome?
dentatorubral tract
corticospinal fibers
corticobulbar tracts
ipsilateral oculomotor nerve palsy
injury, either direct or compressive, to the dorsal midbrain, compression or ischemic damage of the mesencephalic tectum, including the superior colliculus adjacent oculomotor (origin of cranial nerve III) and Edinger-Westphal nuclei, causing dysfunction to the motor function of the eye
Parinaud syndrome
Superior colliculus and midbrain tectum are damaged
Parinaud syndrome
Most often caused by tumors (esp Pineal gland ), also by hydrocephalus, thalamic or midbrain hemorrhage or infraction
Parinaud syndrome `
Vertical gaze abnormalities (esp upgaze)
setting sun sign
Parinaud syndrome
Primary position downbeat nystagmus and
Pretectal pseudobobbing
Parinaud syndrome
Bilateral upper eyelid retraction (tucked lid sign)
Parinaud syndrome
Foville syndrome is casued by blockage of the ?
perforating branches of the basilar artery in the region of the brainstem known as the pons
in the brainstem region, pons
Foville syndrome
Most frequently caused by vascular disease or tumors involving the dorsal pons
Foville syndrome
Foville syndrome occurs in the dorsal pontine tegmentum in the _____
caudal third
Facial N (VII) fascicle, PPRF, corticospinal tract affected
PPRF= paramedian pontine retucular formation
Foville syndrome
causes Ipsilateral peripheral VII palsy, horizontal gaze
paralysis, contralateral hemiparesis, hemisensory loss
Foville syndrome `
injury direct or compressive to dorsal midbrain causing damage to mesencephalic tectum including superior colliculs adjacent oculomotor and edinger-westphal nuclei
parinaud
parinaud syndrome is usually due to tumors pressing on the _____
pineal gland
can also be due to hydrocephalus, midbrain hemorrhage or infarction, paraneoplastic syndrome , wilson, whipple disease TB, drugs
damage to edinger westphal nucleo
parinaud syndrome
peripheral VII palsy is AKA?
bells palsy
name for upper dorsal pontine syndrome
Raymond Cestan Syndrome
name for dorsal midbrain syndrome
parinaud
caused by blockage of the long circumferential branches of the basilar artery
Raymond cestan syndrome
ipsilateral ataxia
ipsilateral paralysis of muscles of mastication and sensory loss in face
contralateral loss of sensory modalities in the body
contralateral hemiparesis of face and body
horizontal gaze palsy
Raymond cestan syndrome
damage to superior and middle cerebellar peduncle causes?
ipsilateral ataxia
damage to sensory and motor nuclei and tracts of CN V causes
ipsilateral paralysis of muscles of mastication and sensory loss in face
damage to spinothalamic tract and medial leminiscus causes
contralateral loss of sensory modalities in the body
Damage to lower dorsal pontine syndrome causes?
horizontal gaze palsy
what syndrome is due to damage to:
medial lemniscus and spinal thalamic tract
cerebellar peduncles
MLF
Cortical spinal tracts (if ventral extension)
contralateral loss of sensory modalities in the body
Syndrome that causes:
paralysis of CN VI
disruption of CN VII
disruption of corticospinal tract
millard gubler syndrome
name for ventral pontine syndrome
millard gubler syndrome
Syndrome that causes:
Dyplopia, internal strabismus, loss of power to rotate eye outward, flacid paralysis of facial expression muscles, loss of corneal reflex, and contralateral hemiplegia of extremities
millard gubler syndrome
name for lateral pontine syndrome
marie foix syndrome
unilateral lesion to ventrocudal pons
millard gubler syndrome
lateral pontine lesions at brachium pontis, including middle cerebellar peduncle
marie foix syndrome
Syndrome that causes: ipsilateral cerebellar ataxia (arm and leg) contralateral hemiparesis contralateral hemi hypesthesia contralateral weaknes hemisensory loss
marie foix syndrome
syndrome that is caused by damage to:
cerebrellar tracts
corticospinal tracts
spinothalamic tract
marie foix syndrome
name for lateral medullary syndrome
wallenberg syndrome
caused by damage to intracranial vertebral artery
wallenberg syndrome
affects: trigeminal spinal nucleus tract spinothalamic tract nucleus ambiguus (CN IX, X) descending sympathetic fibers vestibular nuclei inferior cerebellar peduncle
wallenberg syndrome
damage to trigeminal spinal nucleus tract causes?
ipsilateral loss of pain and temp from face
damage to spinothalamic tract causes?
contralateral loss of pain and temp. from lower trunk extremities
damage to descending sympathetic fibers causes?
horner syndrome (ptosis, miosis, hemianhydrosis, vasodilation, and apparent enophthalmos)
damage to vestibular nuclei causes
nystagmus, nausea, vomiting, and vertigo
damage to inferior cerebellar peduncle causes?
ipsilateral cerebellum signs - dystaxia, dysmetria, dysphonis
syndrome that presends horner syndrome
wallenberg syndrome
Syndrome that presents with:
ipsilateral paresis atrophy fibrillation of tongue (flacid paralysis)
contralateral hemiplegia (sparing face)
contralateral loss of proprioception and vibration
Dejerines syndrome
caused by damage to vertebral artery, anterior spinal artery, or lower segment of basilar
Dejerines syndrome
this syndrome is caused by damage to:
pyramid
medial leminiscus
hypoglossal nerve and nucleus
Dejerines syndrome
