Clinical Syndromes of the Brainstem

Question 1

Only extra-medullary lesions can affect multiple cranial nerves without involving

Answer 1

Long tracts

Question 2

Localization will depend on use of long tract signs and

Answer 2

Cranial nerve dysfunction

Question 3

Of course, long tracts are sensitive throughout the brainstem, whereas cranial nerve nuclei and nerves are more

Answer 3

Restricted

Question 4

What is contained in the medial brainstem?

Answer 4

CST, ML, and Motor cranial nerves (III, IV, VI, VII, IX-XII)

Question 5

What is contianed in the lateral brainstem?

Answer 5

STT, spinocerebellar tract, Sensory CNs V and VIII and descending sympathetics

Question 6

Can indicate the lesion side and whether it is medial or lateral

Answer 6

Long Tracts

Question 7

Remember, the long tracts are entirely crossed from the

Answer 7

Medulla to the midbrain

Question 8

Thus, there will be so-called CROSSED SYNDROMES, in which

1. ) Cranial nerve facial dysfunction and cerebellar problems are
2. ) Long tract signs are

Answer 8

1. ) Ipsilateral to a lesion

2. ) Contralateral to a lesion

Question 9

Lateral medullary (Wallenberg) Syndrome is due to a deficit in

Answer 9

PICA

Question 10

Lateral Pontine Syndrome is caused by a deficit in

Answer 10

AICA

Question 11

Midbrain (Weber’s) Syndrome is due to a deficit in the

Answer 11

Posterior Cerebral Artery

Question 12

Weber syndrome + Claude syndrome =

Answer 12

Benedikt Syndrome (a midbrain syndrome)

Question 13

A state that resembles impaired consciousness, and can be mistaken for coma

Answer 13

Locked-in Syndrome

Question 14

Consciousness consists of three distinct processes. These are

Answer 14

Alertness, attention, and awareness

Question 15

Depends on the ascending reticular activating system

Answer 15

Alertness

Question 16

Depends on monoamines, especially norepinephrine

Answer 16

Attention

Question 17

With locked-in syndrome, patients are conscious and may communicate through

Answer 17

Vertical eye movements or blinks

Question 18

A ventral pons lesion that usually results from an ischemic stroke of the basilar artery can cause

Answer 18

Locked-in syndrome

Question 19

Other etiologies include traumatic brain injury, brain hemorrhage, or demyelinating disease

Answer 19

Locked-in syndrome

Question 20

Central pntine myelinosis is also called

Answer 20

Osmotic demyelination syndrome

Question 21

Has the symptoms of acute paralysis, dysarthria, dysphagia, diplopia, loss of consciousness

Answer 21

Osmotic demyelination syndrome

Question 22

Massive axonal demyelination in pontine white matter secondary to osmotic changes

Answer 22

Osmotic demyelination syndrome

Question 23

Osmotic demyelination syndrome is caused by overly rapid correction of

Answer 23

Hyponatremia