Brainstem Syndromes and CN Disorders

Question 1

Name the part of the brain:
Ventral bridge to hemispheres

Contains which CN?

Answer 1

Midbrain

CN3, CN4

Question 2

Name the part of the brain:
Dorsal to cerebellum

Contains which CN?

Answer 2

Pons

Corticospinal tract
CN7 wraps around
CN6 exits ventral
CN5 exits lateral

Question 3

Name the part of the brain:
Bridge to spine

Contains which CN?

Answer 3

Medulla

CN8-CN12

Question 4

Order the following medial to lateral:

CN10, Nucleus ambiguous, Spinal V, CN 12

Answer 4

CN12, CN10, Nucleus ambiguous, Spinal V

CN12 most medial b/c exit ventrally to tongue

Question 5

Which of the following is NOT a symptom of midbrain disorder?
A. Extraocular symptoms
B. Facial weakness
C. Diplopia 
D. Somnolence/coma

Answer 5

B. This is a sign of pons disorder

CN3, CN4, aRAS

Question 6

Which of the following is NOT a symptom of Pons disorder?
A. Diplopia
B. Facial weakness
C. Somnolence/coma
D. Vertigo

Answer 6

D. This is a sign of medulla

CN6, CN7, aRAS

Question 7

Which of the following is NOT a symptom of medulla disorder?
A. Coughing
B. Choking
C. Facial weakness
D. Vertigo
E. Tongue weakness
F. Hiccups

Answer 7

C. Sign of pons

CN8, CN9, CN10, CN 12

Question 8

Midbrain strokes caused by which vessels?

Answer 8

Basilar
Posterior Cerebral Artery
Posterior communicating

Question 9

Pons strokes caused by which vessels?

Answer 9

Basilar perforates

Question 10

Medulla strokes caused by which vessels?

Answer 10

Vertebral artery perforates

Question 11

Vertebral artery perforator or PICA occlusion causes ____

Answer 11

Lateral medullary syndrome

Question 12

Anterior spinal artery occlusion causes ____

Answer 12

Medial medullary syndrome

Question 13

Lacunar ischemic stroke in pons causes ___

Answer 13

pure motor symptoms

Question 14

Lacunar ischemic stroke in midbrain causes all of the following EXCEPT:
A. Weber syndrome
B. Ipsilateral hemiparesis
C. Oculomotor nerve palsy 
D. Contralateral hemiplegia

Answer 14

B. Contralateral hemiparesis

Weber syndrome = oculomotor nerve palsy, contralateral hemiparesis, contralateral hemiplegia

Question 15

Lacunar ischemic stroke in medulla causes all of the following EXCEPT:
A. Contralateral body numbness
B. Ipsilateral tongue weakness
C. Contralateral facial numbness
D. Vertigo

Answer 15

C. Ipsilateral facial numbness

Lateral medullary syndrome
Medial medullary syndrome
Locked in syndrome

Question 16

Lacunar ischemic stroke in bilateral anterior spinal arteries cause

Answer 16

Locked-in syndrome

Question 17

Hypertensive hemorrhage mainly affects ___

Answer 17

pons

Question 18

Non-pupil sparing CN3 palsy suggests

Answer 18

Posterior communicating aneurysms

Question 19

Pupil sparing CN3 palsy suggests

Answer 19

Diabetic 3rd

Question 20

Name the CN disorder:

Extreme lancing electrical pain worse w/ skin touch, cold, chewing, brushing teeth

Answer 20

Trigeminal neuralgia (CN5)

Question 21

Treatment for Trigeminal neuralgia

Answer 21

Carbamazepine

Question 22

Name the CN disorder:

Facial weakness involving forehead and lower face

Answer 22

Bell’s Palsy (CN7)

Nerve regrowth may cause crocodile tears

Question 23

Name the CN disorder:

Slow growing tumor of Schwann cells

Answer 23

Acoustic Schwannoma (CN8)

Causes hearing loss, imbalance
Genetic: associated w/ NF-2

Question 24

Evaluation for carcinomatous meningitis includes:

Answer 24

MRI and gadolinium

Lumbar puncture

Question 25

Retroparotid/retropharyngeal space contains what CNs?

Answer 25

CN9, CN10, CN11, CN12

Question 26

Cavernous sinus contains what CNs?

Answer 26

CN3, CN4, V1, V2, 6

Tolosa-Hut Syndrome