Sheet 11

Question 1

What happens if there is a legion of the vagus nerve?

Answer 1

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


Question 2

What happens if there is a fracture in the foramen magnum or the hypoglossal canal?

Answer 2

(Lower motor neuron lesion)

1) Tongue deviation towards the paralyzed side
2) Muscle atrophy (ipsilateral)

Question 3

What happens if there is an upper motor neuron lesion?

Answer 3

1) No atrophy

2) On protrusion, tongue will deviate to the side opposite to the lesion

Question 4

What are the two arteries that supply the brain stem?

Answer 4

1) Internal carotid artery

2) Vertebral artery 

Question 5

How does the vertebral artery enter the cranial cavity?

Answer 5

Through foramen magnum

Question 6

What are the symptoms of medial medullary syndrome?

Answer 6

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)

Question 7

Which artery is affected in medial medullary syndrome

Answer 7

Anterior spinal artery

Question 8

What are the symptoms of Lateral medullary syndrome?

Answer 8

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)

Question 9

What are the symptoms of vascular lesions of the posterior spinal artery?

Answer 9

1) Ipsilateral loss of proprioception and vibratory sense

2) Ipsilateral loss of pain and temperature sensation from the face

Question 10

What causes Foville syndrome?

Answer 10

Occlusion of the paramedial branches

Question 11

What are the symptoms of Foville syndrome?

Answer 11

1) Ipsilateral abducens nerve paralysis
2) Contralateral hemiparesis
3) Variable contralateral sensory loss reflecting various degrees of damage to the medial lemniscus

Question 12

What is Millard-Gubler syndrome?

Answer 12

The area of damage is shifted laterally to include the root of the facial nerve along with corticospinal fibers.

Question 13

What are the symptoms of Millard-Gubler syndrome?

Answer 13

1) Contralateral hemiparesis

2) Ipsilateral paralysis of the facial muscles

Question 14

What causes midpontine base syndromes?

Answer 14

Occlusion of the paramedial branches and short circumferential branches

Question 15

What are the symptoms of midpontine base syndromes?

Answer 15

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)

Question 16

What causes Weber’s syndrome?

Answer 16

Occlusion of vessels serving the medial portions of the midbrain involving the oculomotor nerve and the crus cerebri

Question 17

What are the symptoms of Weber’s syndrome?

Answer 17

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

Question 18

What is the hallmark of brainstem vascular lesions?

Answer 18

Ipsilateral cranial nerve sign coupled with a contralateral long tract sign

Question 19

What causes Claude syndrome?

Answer 19

Occlusion of vessels serving the central area of the midbrain

Question 20

What are the symptoms of Claude syndrome?

Answer 20

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

Question 21

What is Benedikt syndrome?

Answer 21

Large legion that includes the territories of both the Weber and Claude syndromes

Question 22

What is the major concern in acute tonsillar herniation?

Answer 22

Damage to the ventrolateral reticular area

Question 23

What is Arnold-Chiari syndrome?

Answer 23

Congenital tonsillar herniation