Sheet 11 Flashcards
(23 cards)
What happens if there is a legion of the vagus nerve?
1) Uvula deviates to the healthy side
2) Hoarseness of voice
3) Dysphagia and nasal regurgitation
4) Arrhythmia in the heart
5) Irregularity in the G.I. tract

What happens if there is a fracture in the foramen magnum or the hypoglossal canal?
(Lower motor neuron lesion)
1) Tongue deviation towards the paralyzed side
2) Muscle atrophy (ipsilateral)
What happens if there is an upper motor neuron lesion?
1) No atrophy
2) On protrusion, tongue will deviate to the side opposite to the lesion
What are the two arteries that supply the brain stem?
1) Internal carotid artery
2) Vertebral artery 
How does the vertebral artery enter the cranial cavity?
Through foramen magnum
What are the symptoms of medial medullary syndrome?
1) Contralateral hemiparesis (Pyramidal and corticospinal damage)
2) Contralateral loss of proprioception and vibratory sense (Medial lemniscus)
3) Deviation of the tongue to the ipsilateral side when it is protruded (Hypoglossal root or nucleus injury)
Which artery is affected in medial medullary syndrome
Anterior spinal artery
What are the symptoms of Lateral medullary syndrome?
1) Contralateral loss of pain and temperature sensation from the body (ALS)
2) Ipsilateral loss of pain and temperature sensation from the face (Spinal trigeminal tract and nucleus)
3) Vertigo and nystagmus (vestibular nuclei)
4) Loss of taste from the ipsilateral half of the tongue (solitary tract and nucleus)
5) Hoarseness and dysphagia (nucleus ambiguus or roots of CN 9&10)
6) Ipsilateral Horner syndrome (hypothalamospinal fibers)
What are the symptoms of vascular lesions of the posterior spinal artery?
1) Ipsilateral loss of proprioception and vibratory sense
2) Ipsilateral loss of pain and temperature sensation from the face
What causes Foville syndrome?
Occlusion of the paramedial branches
What are the symptoms of Foville syndrome?
1) Ipsilateral abducens nerve paralysis
2) Contralateral hemiparesis
3) Variable contralateral sensory loss reflecting various degrees of damage to the medial lemniscus
What is Millard-Gubler syndrome?
The area of damage is shifted laterally to include the root of the facial nerve along with corticospinal fibers.
What are the symptoms of Millard-Gubler syndrome?
1) Contralateral hemiparesis
2) Ipsilateral paralysis of the facial muscles
What causes midpontine base syndromes?
Occlusion of the paramedial branches and short circumferential branches
What are the symptoms of midpontine base syndromes?
1) Contralateral hemiparesis(Corticospinal fibers)
2) Ipsilateral loss of pain and thermal sense and paralysis of the masticatory muscles (sensory and motor trigeminal roots)
3) Ataxia (fibers of the middle cerebellar peduncle)
What causes Weber’s syndrome?
Occlusion of vessels serving the medial portions of the midbrain involving the oculomotor nerve and the crus cerebri
What are the symptoms of Weber’s syndrome?
1) Ipsilateral paralysis of all extraocular muscles except the lateral rectus and superior oblique
2) Paralysis of the contralateral extremities
3) Ipsilateral dilation of pupil
4) Contralateral weakness of the facial muscles of the lower half of the face
5) Contralateral deviation of the tongue when it is protruded
What is the hallmark of brainstem vascular lesions?
Ipsilateral cranial nerve sign coupled with a contralateral long tract sign
What causes Claude syndrome?
Occlusion of vessels serving the central area of the midbrain
What are the symptoms of Claude syndrome?
1) Ipsilateral paralysis of most eye-movement; the eye is directed down and out
2) Ipsilateral dilation of pupil
3) Contralateral ataxia, tremor, and incoordination
What is Benedikt syndrome?
Large legion that includes the territories of both the Weber and Claude syndromes
What is the major concern in acute tonsillar herniation?
Damage to the ventrolateral reticular area
What is Arnold-Chiari syndrome?
Congenital tonsillar herniation
