Brainstem SYNDROMES Flashcards
Rule of 4 in Brainstem
4 CN arise from Cerebrum & Midbrain: 1,2,3,4
4 CN arise from PONS: 5,6,7,8
4 CN arise from Medulla: 9,10,11,12
Only Cranial Nerve to arise from DORSAL Aspect of MIDBRAIN
Cranial Nerve 4
Which Cranial nerves arise from Midline
🧠⚡ Rule of 12; Number whose multiple is 12⚡
3,4,6,12
Which Cranial nerves arise from Lateral Part of Brainstem
5,7,8,9,10,11
MEDIAL LONGITUDINAL FASICULUS
(MLF) connects
🧠⚡SEX with 3 others ⚡
6th CN with C/L 3rd CN nucleus
In Any Brainstem Syndrome, most Characteristic is
CROSSED HEMIPLEGIA
⭐ MIDBRAIN is supplied by
⭐ PONS is supplied by
⭐ MEDULLA is supplied by
⭐ MIDBRAIN is supplied by
🎯 P1 of Posterior Cerebral Artery (PCA)
⭐ PONS is supplied by
🎯 Medial Pontine: BASILAR Artery
🎯 Lateral Pontine: AICA
⭐ MEDULLA is supplied by
🎯 MEDIAL MEDULLARY: Anterior Spinal Artery
🎯 LATERAL MEDULLARY: PICA
Midbrain @ SUPERIOR COLLICULUS
🧠⚡Only MIDBRAIN Cross section to be remembered ⚡
Midbrain section @ INFERIOR COLLICULUS
How to differentiate Superior & Inferior COLLICULUS
At Superior COLLICULUS: 3rd CN seen
At Inferior COLLICULUS: 4th CN seen
Midline structures of BRAINSTEM
🧠⚡4M⚡
🧠⚡Midline = Motor ⚡
✨ Motor CN 3,4,6,12
✨ Medial Longitudinal FASICULUS
✨ Medial Leminiscus ➡️ DCML ➡️ VIBRATION & PROPRIOCEPTION
✨ Motor Fibers of Corticospinal Tract ➡️ C/L HEMIPLEGIA
Lateral structures of BRAINSTEM
🧠⚡4S⚡
🧠⚡Sides = Sensory ⚡
- Spinocerebellar Fibers ➡️ ATAXIA
- Spinal Leminiscus (Spinothalamic Tract) ➡️ Carry PAIN & TEMPERATURE from OPPOSITE SAIDE
- Spinal nucleus of Trigeminal nerve
- Sympathetic Fibers ➡️ HORNER’S Syndrome
- CN 5,7,9,10,11
Midbrain Syndromes
🧠⚡all have I/L 3rd CN Palsy ⚡
Ventral Midbrain
1. Weber’s
2. Benedikt’s
3. Claude
Dorsal Midbrain
4. Parinaud
5. Nothnagel
I/L Occulomotor Nerve Palsy
➕
C/L Hemiplegia
Weber’s syndrome
I/L Occulomotor Nerve Palsy
➕
C/L Bobbing Head Movement (Red Nucleus Involvement) or C/L ATAXIA
➕
C/L HEMIBALLISMUS
🧠⚡B for B⚡
Benedikt’s Syndrome
NOTHNAGEL Syndrome
🧠⚡North is Superior ⚡
🧠⚡noThnagel ⚡
TECTUM Involvement ➕
✨ Ataxia
✨ Paralysis of Gaze
CLAUDE Syndrome
🧠⚡C = Combination ⚡
🧠⚡BNC⚡
Combination of Benedikt’s ➕ NOTHNAGEL syndrome
PARINAUD’S SYNDROME
🧠⚡ParinauD ⚡
✨ Pineal Gland related Tumour
Involves 2P:
🎯 Pretectal Nucleus
🎯 Periaqueductal Gray Matter
✨ Dorsal Part Compression (contain Superior COLLICULUS)
⬇️
Superior Gaze Palsy
Sunset sign
Skew Deviation
Collier’s sign
SUNSET sign seen in
- PARINAUD’S SYNDROME
- Hydrocephalus
Collier’s Sign is seen in
PARINAUD’S SYNDROME
✨ Lid Retraction
⚡⚡ MOST COMMON MIDBRAIN SYNDROME
Weber’s SYNDROME
PONTINE SYNDROMES
🧠⚡MRF Locked In⚡
- MILLARD GUBLER SYNDROME
- RAYMOND SYNDROME
- FOVILLE Syndrome
- Locked in Syndrome