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Flashcards in Brainstem Lesion (4-5 stars!) Deck (9):

**Where is the infarction in Weber syndrome? (artery and part of brainstem)

midbrain infarction resulting form paramedian branches of the posterior cerebral artery


**What symptoms are se in Weber syndrome (2)

1. Contralateral hemiparesis (spastic paralysis)--> cerebral peduncle lesion
2. Ipsilateral pupillary dilation, eye is down and out (lateral striabismus)--> due to CN III nucleus involvement

*hemiparesis is contralateral, b/c this is above the place where the corticospinal tract (which runs through the cerebral peduncle in midbrain) has crossed over; does this in the medulla, at the pyramids


**What artery and part of the brain are affected in lateral medullary syndrome (Wallenberg)?

Occlusion of one of the PICA--> unilateral infarct of lateral portion of rostral medulla


**What are 6 symptoms of Lateral Medullary syndrome?

1. Loss of pain/temp over contralateral body (spinothalmic tract)
2. Loss of pain/temp over ipsilateral face (trigeminothalmic tract)
3. Hoarsness, dysphagia, loss of gag reflex (nucleus ambiguus: CN IX and X damage)
4. Ipsilateral Horner's syndrome (descending sympathetic tract damage)
5. Vertigo, nystagmus, N/V (vestibular nuclei damage)
6. Ipsilateral cerebellar deficits (inf. cerebellar ped. dmg)


In what syndrome would you see tongue deviation and hemiparesis towards the other side? What artery occluded?

Medial medullary syndrome--> occlusion of anterior spinal artery (paramedian branches of)


Eye cant adduct when looking away from lesion, other eye has nystagmus

MLF lesion; aka internuclear opthalmoplegia


What should be suspected in pts under 50 if internuclear opthalmoplegia is seen? over 50?

under 50--> Multiple sclerosis
over 50--> stroke


Lesion where can cause locked-in syndrome

superior pons


Two causes of locked in syndrome

1. Basilar artery stroke (classically)
2. Hyponatremia corrected too quickly (Central pontine myelinolysis)

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