High-Yield Lesions Flashcards by Bridget foley | Brainscape

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Paramedian: infarction of paramedian branches of the basilar a.

I/L oculomotor palsy (oculomotor nucleus or radiations)
B/L downgaze palsy (commissural fibers connecting both oculomotor nuclei)
B/L ataxia (decussation of SCP)
C/L ataxia (cerebellothalamic fibers rostral to SCP)

**If lesion extends to posterior thalamus:

confusions
amnesia
sleep disturbance

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Short circumferential territory: branches of the basilar a.

I/L oculomotor palsy (oculomotor nucleus or radiations)
C/L spasticity (CST in CC0

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Caudal Long Circumferential

I/L oculomotor palsy (oculomotor nucleus or radiations)
C/L loss of discriminative sensory from UE (inferior ML)
C/L UE & LE ataxia (cerebellothalamic fibers above the level of decussation)
C/L choreoathetotic movement (palladiothalamic fibers passing through the base of the internal capsule)

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Rostral Long Circumferential

I/L oculomotor palsy (oculomotor nucleus or radiations)
C/L discriminative sensory loss LE>UE (rostral ML)
C/L UE & LE ataxia (cerebellothalamic fibers rostral to decussation)
C/L UE & LE choreoathetotic movement (palladiothalamic fibers passing through the rostral aspect of internal capsule)

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Parinaud’s Syndrome

B/L upgaze palsy (commissural fibers between oculomotor nuclei crossing above cerebral aqueduct)

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Thalamus: Paramedian territory

confusion & dementia (DM nucleus)
amensia with confabulation (mamillary bodies and mammillothalamic tract)
sleep disturbance (hypothalamus)

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Anterolateral thalamic lesion: tuberothalamic branches from posterior communicating artery

Neuropsych changes: language, intellect, memory
dysphasias, neglect, abulia (anterior and ventral anterior nuclei of thalamus)
C/L emotional facial paralysis (median forebrain bundle)

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Lateral thalamus lesion

C/L homonymous hemianopia (optic radiations)
C/L spastic paresis/paralysis (CST in CC)

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Posterolateral thalamic lesion (posteromedial choroidal vessels from the PCA and posterior communicating arteries)

C/L hemibody sensory loss (ventroposterior nuclei or ML)
C/L homonymous hemianopia (optic tract, LGB)
C/L hemipelegia/paresis (CST in IC)
C/L hemichorea or athetosis (VL and VA nuclei or palladiothalamic fibers)

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