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Neurology 2 > Stephens Brainstem Lesions > Flashcards

Stephens Brainstem Lesions Flashcards

1
Q

Internuclear ophthalmoplegia

A

MLF lesion
Can’t adduct ipsilateral eye
Nystagmus of contralateral eye on abduction

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2
Q

Corticobulbar fibers

Decussate where?

A

Motor nerves to cranial nerve motor nuclei

Lower pons (between CN5 and CN6)

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3
Q

Supranuclear facial palsy

A

CBT lesion above decussation in lower pons

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4
Q

Uvula deviation

A

Contralateral to nucleus ambiguus affected

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5
Q

Tongue protrusion

A

Ipsilateral hypoglossal nucleus affected

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6
Q

Loss of corneal reflex

A

Ipsilateral motor nucleus of VII

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7
Q

Diminished jaw-jerk reflex

A

Ipsilateral motor nucleus of V

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8
Q

Pupillary dilation and bad accommodation

A

Edinger-Westphal nucleus

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9
Q

Loss of lacrimation from lacrimal gland

A

Superior salivatory nucleus

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10
Q

Loss of salivation from parotid gland

A

Inferior salivatory nucleus

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11
Q

External strabismus + complete ptosis

A

Oculomotor palsy

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12
Q

Loss of prop/2-pt from half of face

A

Ipsilateral sensory nucleus of V

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13
Q

Loss of p/t from half of face

A

Ipsilateral decending nucleus/tract of V

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14
Q

Nystagmus

A

Vestibular n. (CN 8) issue

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15
Q

Deficit patterns of central lesions

A 
Hemianalgesia, hemianesthesia
Spastic paralysis
Bilateral deficits
Supranuclear facial palsy
Systemic disorders/diseases
Visual field pattern blindness
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16
Q

Important parts of spinal cord

A

LSTT (Contralateral P/T)
Fasciculus gracilis/cuneatus (Prop/2-pt)
LCST (UMNs)
Anterior commissure (P/T)

17
Q

Important parts of brainstem

A 
Cranial nerves
SL (Contralateral body P/T)
ML (Contralateral body prop/2-pt)
TL (Contralateral face P/T)
LL (Contralateral hearing deficits)
CST (Contralateral body UMNs)
CBT (Ipsilateral facial motor neurons)
18
Q

Cranial nerves that exit anteriorly near CST

A

Hypoglossal
Abducens
Trigeminal
Oculomotor

19
Q

Cranial nerves that exit near SL

A 
Trigeminal
Facial
Glossopharyngeal
Vagus
Spinal Accessory
20
Q

Lesions of V, VII, IX, X, or XI

A

Can include contralateral P/T loss from body

21
Q

Lesions of III, V, VI, XII

A

Can include contralateral spastic hemiplegia of body

22
Q

List all A12H combos (w/ names)

Level?

A

A12H
A12H + contralateral CST (midline extension)
A12H + ML (dorsal extension)

Medulla at olive

23
Q

List all A6H combos (w/ names)

Level?

A

A6H
Millard-Gubler (A6H + 7) (lateral extension)
Syndrome of Foville (A6H + ML) (dorsal extension)

Pons at facial colliculus

24
Q

List all A5H combos (w/ names)

Level?

A

A5H
A5H + ML + uncrossed CBT (dorsal extension)

Pons at trigeminal n

25
Q

List all A3H combos (w/ names)

Level?

A

Weber’s Syndrome (A3H + uncrossed CBT + SN)

Diencephalon/midbrain at white commissure

26
Q

Dysphagia, dysarthria, dysphonia
Contralateral loss of P/T to body
(Maybe ML symptoms)

Level?

A

Lesion of Nucleus Ambiguus and SL

Medulla at olive

27
Q

Loss of P/T from face
Contralateral loss of P/T from body
IX, X, spinocerebellar, vestibular symptoms

Level?

A

Wallenberg’s Syndrome (Alternating Hemianalgesia)

Medulla at olive

28
Q

Deafness, vestibular disturbances
Bell’s palsy
Alternating Hemianalgesia
Cerebellar problems

Level? Cause?

A

Cerebellopontine Angle (CPA) Syndrome

Medulla at olive
Cause = acoustic neuroma

29
Q

Oculomotor palsy
Contralateral loss of prop/2-pt of body
Contralateral motor dysfunction (tremor, ataxia)

Level?
Importance of this one?

A

Benedikt’s Syndrome (Midbrain tegmentum - red nucleus)

Diencephalon/Midbrain at posterior commissure
WHERE LEMNISCAL SYSTEMS ARE ADJACENT

30
Q

Paralysis of upward gaze
Loss of consensual light reflex

Cause?

A

Parinaud’s Syndrome

Pineal tumor impinges on superior colliculus (upward gaze) and posterior commissure (consensual light reflex)

31
Q

Contralateral hemianesthesia (P/T and prop/2-pt)

A

Unilateral lesion of VPM/VPL nuclei (thalamus)

32
Q

Diffuse spontaneous pain without stimulus
Extreme mood swings
Contralateral tingling/crawling ant feeling, hemiparesis, homonymous hemianopia, or auditory deficits

Cause?

A

Thalamic syndrome

Thrombosis of posterior choroidal or deep PCA branches

Neurology 2 (22 decks)

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