Stroke Syndromes Flashcards
What occurs with lesion to the red nucleus?
- loss of fine tuning of the movements
- > TREMOR AND ATAXIA
What occurs with lesion to the Medial Longitudinal Fasciculus?
- Internuclear Ophthalmoplegia
problems with lateral gaze
What occurs in Benedikt Syndrome?
- STROKE in the central midbrain
- —red nucleus/ CN3 and Medial leminiscus is affected#
What does the medial leminiscus do?
- continuation of the Posterior column (relays info. on proprioception and vibration)
What are the symptoms of Bendikt syndrome?
- Down and Out eye+ Pupil dilation
- C/L Loss of proprioception and vibration
- Involuntary movements (TREMOR AND ATAXIA)
What occurs in Weber’s Syndrome? What is affected?
- antero-lateral, Midbrain stroke
- —CN3/ corticobulbar/ corticospinal tracts are affected
How does Weber’s syndrome present as?
- CN3 Palsy
- C/L hemiparesis
- pseudobulbar palsy
How to confirm dx of pseudobulbar palsy?
- Exaggerated GAG reflex and JAW reflex
- Spastic tongue
- Spastic dysarthria
- —-UMN lesion signs
What is affected in Perinaud’s Syndrome?
- posterior aspect of the Midbrain
- SUPERIOR COLLICULUS and the PRETECTAL area
What are signs of Perinaud’s Syndrome?
- Vertical Gaze Palsy
2. Pseudo Argyll Robertson Pupil
What is Pseudo Argyll Robertson Pupil ?
- when the pupil does NOT constrict with LIGHT but it constricts with ACCOMMODATION
What is said to cause Perinaud’s Syndrome?
- pineal tumor (Pinealoma/ Germinoma)
What may occur with progressive pineal tumor growth?
- obstruction of the Cerebral Aqueduct
Describe the course of CN7 leaving pons.
- does a “round-about” around CN6 and then leaves
What is responsible for PAIN and T* sensation on the face? Where in the brain stem is it located?
- Spinal tract and the Nucleus Trigeminal
- — found in PONS
What is PPRF responsible for?
- LATERAL gaze
paramedian pontine reticular formation
Name 3 key fts in the PONS, repsonsible to look left or right. Where are they found?
- Abducens N.
- PPRF
- MLF
- —-close to each other in the midline of PONS
What is affected in MEDIAL PONTINE $?
- CN 6
- CN 7
- Corticospinal tract
- —-and the lateral gaze structures
What is seen with sx in medial pontine $?
- ipsilateral CN 6 PALSY: diplopia and lateral gaze palsy
- ipsilateral facial droop
- c/l hemiparesis
- -ipsilateral? gaze palsy
What is affected in the LATERAL pontine syndrome?
- Vestibular Nucleus
- Spinothalamic tract
- Sympathetic tract
- Spinal V nucleus
- CN 7 palsy
What signs seen in the Lateral Pontine syndrome?
- nystagmus, N.V, vertigo
- c/l pain and T* loss on limbs
- HORNER’S syndrome (ipsilateral)
- ipsilateral loss of facial pain/T*
- ipsilateral FACIAL droop and LOSS of corneal reflex
- ….deafness (if cochlea nucleus is damaged)
Stroke involving which artery is resp. for LATERAL pontine syndrome?
- AICA
Anterior inferior Cerebellar artery
What artery supplies the midbrain?
Posterior Cerebral Artery
What does the dorsal MOTOR nucleus X and the Nucleus solitarius recieve?
Autonomic sensory info.
