Brainstem SYNDROMES Flashcards

(55 cards)

1
Q

Rule of 4 in Brainstem

A

4 CN arise from Cerebrum & Midbrain: 1,2,3,4
4 CN arise from PONS: 5,6,7,8
4 CN arise from Medulla: 9,10,11,12

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2
Q

Only Cranial Nerve to arise from DORSAL Aspect of MIDBRAIN

A

Cranial Nerve 4

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3
Q

Which Cranial nerves arise from Midline
🧠⚡ Rule of 12; Number whose multiple is 12⚡

A

3,4,6,12

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4
Q

Which Cranial nerves arise from Lateral Part of Brainstem

A

5,7,8,9,10,11

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5
Q

MEDIAL LONGITUDINAL FASICULUS
(MLF) connects
🧠⚡SEX with 3 others ⚡

A

6th CN with C/L 3rd CN nucleus

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6
Q

In Any Brainstem Syndrome, most Characteristic is

A

CROSSED HEMIPLEGIA

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7
Q

⭐ MIDBRAIN is supplied by
⭐ PONS is supplied by
⭐ MEDULLA is supplied by

A

⭐ MIDBRAIN is supplied by
🎯 P1 of Posterior Cerebral Artery (PCA)

⭐ PONS is supplied by
🎯 Medial Pontine: BASILAR Artery
🎯 Lateral Pontine: AICA

⭐ MEDULLA is supplied by
🎯 MEDIAL MEDULLARY: Anterior Spinal Artery
🎯 LATERAL MEDULLARY: PICA

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8
Q

Midbrain @ SUPERIOR COLLICULUS

🧠⚡Only MIDBRAIN Cross section to be remembered ⚡

A
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9
Q

Midbrain section @ INFERIOR COLLICULUS

A
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10
Q

How to differentiate Superior & Inferior COLLICULUS

A

At Superior COLLICULUS: 3rd CN seen
At Inferior COLLICULUS: 4th CN seen

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11
Q

Midline structures of BRAINSTEM
🧠⚡4M⚡
🧠⚡Midline = Motor ⚡

A

✨ Motor CN 3,4,6,12
✨ Medial Longitudinal FASICULUS
✨ Medial Leminiscus ➡️ DCML ➡️ VIBRATION & PROPRIOCEPTION
✨ Motor Fibers of Corticospinal Tract ➡️ C/L HEMIPLEGIA

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12
Q

Lateral structures of BRAINSTEM
🧠⚡4S⚡
🧠⚡Sides = Sensory ⚡

A
  1. Spinocerebellar Fibers ➡️ ATAXIA
  2. Spinal Leminiscus (Spinothalamic Tract) ➡️ Carry PAIN & TEMPERATURE from OPPOSITE SAIDE
  3. Spinal nucleus of Trigeminal nerve
  4. Sympathetic Fibers ➡️ HORNER’S Syndrome
  5. CN 5,7,9,10,11
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13
Q

Midbrain Syndromes
🧠⚡all have I/L 3rd CN Palsy ⚡

A

Ventral Midbrain
1. Weber’s
2. Benedikt’s
3. Claude

Dorsal Midbrain
4. Parinaud
5. Nothnagel

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14
Q

I/L Occulomotor Nerve Palsy

C/L Hemiplegia

A

Weber’s syndrome

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15
Q

I/L Occulomotor Nerve Palsy

C/L Bobbing Head Movement (Red Nucleus Involvement) or C/L ATAXIA

C/L HEMIBALLISMUS

🧠⚡B for B⚡

A

Benedikt’s Syndrome

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16
Q

NOTHNAGEL Syndrome
🧠⚡North is Superior ⚡
🧠⚡noThnagel ⚡

A

TECTUM Involvement ➕
✨ Ataxia
✨ Paralysis of Gaze

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17
Q

CLAUDE Syndrome
🧠⚡C = Combination ⚡
🧠⚡BNC⚡

A

Combination of Benedikt’s ➕ NOTHNAGEL syndrome

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18
Q

PARINAUD’S SYNDROME
🧠⚡ParinauD ⚡

A

✨ Pineal Gland related Tumour
Involves 2P:
🎯 Pretectal Nucleus
🎯 Periaqueductal Gray Matter

✨ Dorsal Part Compression (contain Superior COLLICULUS)
⬇️
Superior Gaze Palsy
Sunset sign
Skew Deviation
Collier’s sign

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19
Q

SUNSET sign seen in

A
  1. PARINAUD’S SYNDROME
  2. Hydrocephalus
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20
Q

Collier’s Sign is seen in

A

PARINAUD’S SYNDROME
✨ Lid Retraction

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21
Q

⚡⚡ MOST COMMON MIDBRAIN SYNDROME

A

Weber’s SYNDROME

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22
Q

PONTINE SYNDROMES
🧠⚡MRF Locked In⚡

A
  1. MILLARD GUBLER SYNDROME
  2. RAYMOND SYNDROME
  3. FOVILLE Syndrome
  4. Locked in Syndrome
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23
Q

Cranial Nerves arising from PONTOMEDULLARY JUNCTION

24
Q

If Cranial nerves 6, 7, 8 lesioned, lesion lies at

A

Lower Level of Pons

25
Millard GUBLER SYNDROME 🧠⚡ 7 letters & 6 letters⚡
6th & 7th CN palsy Spares the NUCLEUS only affects the Nerve Fibers
26
FOVILLE SYNDROME 🧠⚡ 7 letters⚡
7th CN Palsy ➕ Lateral Gaze Palsy
27
RAYMOND Syndrome 🧠⚡Ond = 1 nerve only ⚡
6th CN affected
28
LOCKED IN SYNDROME
B/L Ventral PONTINE Involvement
29
Medial Medullary Syndrome Synonym
Dejerine Syndrome
30
Features of DEJERINE Syndrome 🧠⚡4M⚡
1. Cranial Nerve 12 affected ➡️ Gets DEVIATED to same side 2. Medial Leminiscus affected ➡️ C/L Proprioception Loss 3. Motor Corticospinal Tract affected ➡️ C/L Hemiplegia 4. MLF lesion ➡️ Intranuclear Opthalmoplegia
31
⭐ PICA Involvement leads to ⭐ AICA Involvement leads to
⭐ PICA Involvement leads to 🎯 Lateral Medullary Syndrome ⭐ AICA Involvement leads to 🎯 Lateral Pontine Syndrome
32
AICA Involvement 🧠⚡fACIAl⚡
7th CN palsy ➕ SNHL (DUE TO: Labyrinthine artery Involvement)
33
Wallenberg syndrome Synonyms
✨ Lateral Medullary Syndrome ✨ PICA syndrome
34
Features of Wallenberg Syndrome 🧠⚡ 5S⚡
1. Spinal Nucleus of Trigeminal Nerve ( 5th CN) affected ➡️ I/L Face Sensation Lost 2. Nucleus Tractus Solitarius affected ( 7th CN) ➡️ Loss of Taste in Anterior ⅔rd of Tongue 3. Nucleus ambiguus affected ( 9th & 10th CN) ➡️ Palatal Palsy, Dysphagia, Hoarseness, Nasal Regurgitation 4. Spinocerebellar fibers affected ➡️ I/L Ataxia 5. Spinothalamic Fibers affected ➡️ C/L Pain & Temperature 6. Sympathetic abnormalities
35
PICA Involvement 🧠⚡PICAchew ⚡
Chewing Difficulty ➡️ Dysphagia in Lateral Medullary Syndrome
36
Identify
Medulla Oblongata Cross Section
37
Identify
Weber Syndrome
38
Identify
Benedikt's Syndrome
39
Identify
Claude's symdrome
40
Causes of ARGYLL ROBERTSON PUPIL
1. Neurosyphilis 2. PARINAUD'S SYNDROME
41
Pretectal Nucleus is responsible for
Light Reflex Pathway
42
ARGYLL ROBERTSON PUPIL 🧠⚡ ARP , PRA⚡
Accomodation Reflex Present Positive Light Reflex Absent
43
Marie Foix Syndrome
Lateral Pontine Syndrome
44
Avellis Syndrome
10th CN ➡️ Paralysis of Soft Palate & Vocal Cord ➕ Spinothalamic Tract ➡️ C/L Hemianesthesia
45
Site of AVELLIS Syndrome & Jackson Syndrome
Tegmentum of Medulla
46
Jackson Syndrome
Avellis syndrome ➕ I/L 12th CN palsy ➡️ Tongue Syndrome
47
Cruciate Paralysis Meaning
Arm weakness on 1 SIDE ➕ Leg Weakness on Other SIDE
48
⚡⚡ MOST COMMON CAUSE OF LATERAL MEDULLARY Syndrome
V4 Segment of VERTEBRAL ARTERY > PICA
49
Pseudo Abducent Nerve Palsy seen in ⭐ CAUSE
Parinaud's syndrome Cause: CONVERGENT CENTER Overactivity
50
Convergent Refractive Nystagmus seen in
Parinaud's syndrome
51
⭐ Parinaud's Syndrome is Caused DUE TO: ⭐ Parinaud's Occuloglandular Syndrome is Caused DUE TO:
⭐ Parinaud's Syndrome is Caused DUE TO: 🎯 Pinealoma ⭐ Parinaud's Occuloglandular Syndrome is Caused DUE TO: 🎯 Francisella Tularensis (Tularemia)
52
Cause of COLLIER'S Sign
Overactive LPS ⬇️ DUE TO: End neurons
53
Everything is lost I/L in WALLENBURG Syndrome, except
C/L Pain & Temperature Spinothalamic Fibers
54
What is considered as Cranial Nerve 13
Sympathetic chain
55
Which Lateral Nerve is spared in WALLENBURG Syndrome
CN 11 LOCATED VERY DOWN