Brainstem Lesion (4-5 stars!) Flashcards Preview

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Flashcards in Brainstem Lesion (4-5 stars!) Deck (9):
1

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

midbrain infarction resulting form paramedian branches of the posterior cerebral artery

2

**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

3

**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

4

**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)

5

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)

6

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

MLF lesion; aka internuclear opthalmoplegia

7

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

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

8

Lesion where can cause locked-in syndrome

superior pons

9

Two causes of locked in syndrome

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

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