VIII- Lesions

Question 1

rostral midbrain components

Answer 1

tegmentum + tectum (sup colliculi) + substantia nigra + crus cerebri

basis pedunculi = substantia + crus
cerebral peduncle = tegmentum + basis

Question 2

nuclei in rostral midbrain

Answer 2

1. edinger westphal
2. oculomotor
3. red nucleus

Question 3

midbrain blood supply

Answer 3

posterior cerebral A

Question 4

Weber Syndrome

Answer 4

medial midbrain (rostral) lesion
ipsilateral oculomotor palsy + contralat cotricospinal and corticonuclear damage

Question 5

claude syndrome

Answer 5

central midbrain (tegmentum) lesion
-oculomotor ipsilateral palsy + ataxia tremor contralat
-damage cerebellothalamic fibers

Question 6

benedict syndrome

Answer 6

medial and central midbrain lesions
-damage to red nucleus + oculomotor N + corticospinal/nuclear tracts + substantia nigra

ipsilateral oculomotor palsy + weak contralat uvula + weak contralat face + tongue deviate contralat + jaw deviate to weak side

Question 7

oculomotor nerve palsy

Answer 7

ipsilateral to lesion
-for all syndromes

Question 8

corticonuclear projections- damage

Answer 8

1. trigeminal - lesion damage lateral pterygoid muscle bc contralateral
2. facial nucleus - damage lower half
3. nucleus ambiguus = musculus uvulae weak
4. hypoglossal nucleus = genioglossus muscle damage

Question 9

cerebellar lesion =

Answer 9

ipsilateral deficits

Question 10

blood supply to the pons

Answer 10

basilar A > paramedian penetrating A’s

Question 11

dysarthria hemiparesis syndrome

pure motor hemiparesis

Answer 11

lesion in medial pontine basis
-contralat weakness in UE and LE + lower face + dysarthria from speech muscle damage
-damage corticospinal and nuclear tract (UMN only)

Question 12

ataxic hemiparesis syndrome

Answer 12

damage to corticonuclear and spinal + pontine nuclei + pontocerebellar fibers @ ventral pons
-contralat ataxia + lower face/UL/LL weakness + dysarthria

Question 13

pontine wrong way eyes syndrome

Answer 13

eyes can look to side of weakness but not to side of pontine lesion

Question 14

millard gubler syndrome

Answer 14

ipsilateral facial weak + contralat UL/LL weak + contralat lower face weak + dysarthria

Question 15

AICA syndrome

Answer 15

1. ipsilat ataxia (middle cerebellar peduncle)
2. vertigo, nytagmus (vestibular nuclei)
3. ipsilat face dec pain and thermal sensory (trigem nuc/tract)
4. contralat body dec pain and thermal (spinothalamic tract)
5. ipsilat Horner’s syndrome (sympathetics)

Question 16

medial medullary syndrome

Answer 16

1. contralat hemiparesis
2. weak ipsilat tongue, atrophy muscles
3. contralat DCML function (vibratory, prop, discrim touch)