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23 Cards in this Set
- Front
- Back
Midline tumor in tegmentum of rostral pons |
Reticular Core (including central tegmental tracts) = arousal mechanisms severely impaired, level of consciousness dep. on lesion size; enhanced extensor antigravity tone w/ possibility of decerebrate posture Medial longitudinal fasciculus (MLF) = inability to adduct eyes on lateral gaze |
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Meningeal tumor pressing on inferior colliculus (rostral pons) |
Nucleus of inferior colliculus/termination of lateral lemniscus = bilateral hearing loss, more pronounced on side opposite lesion |
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Thrombosis of branch of superior cerebellar artery or tumor mass in midline of tegmentum of rostral pons |
Decussation of superior cerebellar peduncles = ataxia, bilateral cerebellar dyssynergia, including dysdiachokinesia, dysmetria, and decomposition of movements; bilateral intention tremor Reticular core = deficits in consciousness proportional to size of lesion |
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Superior alternating hemiplegia (Weber's) - thrombosis of branch of posterior cerebral a. or tumor at base of rostral midbrain |
Crus cerebri (CST & CBT) = contralateral spastic hemiparesis/paralysis; C. loss of cutaneous reflexes, hyperactive c. deep tendon reflex, clonus, c. extensor plantar (Babinski), c. lower facial paralysis (can wrinkle forehead, can't smile); sudden onset jaw/tongue deviation to side opposite lesion Oculomotor (3) nerve root = Ipsilateral external strabismus, diplopia, ipsi ptosis, ipsi mydriasis, absence of direct light reflex in ipsi eye & loss of consensual response when light is shone in eye opposite lesioned side. |
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Benedikt's - tumor in tegmentum of rostral midbrain |
Oculomotor (3) nerve root = Ipsilateral external strabismus, diplopia, ipsi ptosis, ipsi mydriasis, absence of direct light reflex in ipsi eye & loss of consensual response when light is shone in eye opposite lesioned side. Red nucleus/superior cerebellar peduncle (rostral to decussation) = ataxia, contra. dyssynergia, including dysdiachokinesia, dysmetria, and decomposition of movements; contra. intention tremor Ascending sensory fibers, including ML, ALS, and ventral trigeminal tract = Contralateral loss of fine touch, proprioception, deep pressure sensation, pain, temp in body and face |
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Parkinsonism - degeneration of pars compacta of substantia nigra |
Substantia nigra = contra. rigidity of musculature, cog-wheel phenomenon, contra. tremor at rest (pill rolling), contra bradykinesia **Note = may start on one side of brain and spread to other side; loss of associated movements (swinging arms when walking, blinking, spontaneous gesturing) posture and righting reflexes occur with progression; emotional behavior affected. |
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Tumor at base of caudal diencephalon (rostral midbrain section) |
Lateral geniculate/termination of optic tract = contralateral homonymous hemianopsia |
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Parinaud's - occurring from pinealoma or tumor or pineal gland (diencephalon/midbrain transition) |
Pineal gland tumor presses on centers for vertical gaze & rostral superior colliculi (more caudally) = paralysis of upward gaze (initially); paralysis of downward gaze occurs later as tumor expands |
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Thrombosis of branch of posterior cerebral artery (caudal thalamus) |
VPM & VPL = contralateral body and face loss of fine touch, conscious proprioception, and deep pressure sensation; inability to localize pain on contralateral body and face (without losing ability to perceive it) |
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Thrombosis of branch of thalamosubthalamic a. (branch of post. cerebral a.) - mid thalamus/subthalamus/caudal hypothalamus |
Subthalamic nucleus = contralateral hemiballism, mild hypotonia of affected muscles |
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Thrombosis of a branch of post. cerebral a. or tumor mass in crus cerebri at base of caudal diencephalon |
Internal capsule/cerebral peduncle = contra spastic hemiparesis/paralysis; jackknife phenomenon, contra loss of cutaneous reflexes, hyperactive deep tendon reflexes; contra extensor plantar reflex (Babinski); contra lower facial paralysis (can't smile but can wrinkle forehead) Optic tract = contra homonymous hemianopsia **Note = following a lesion of sudden onset (thrombosis), transient deviation of jaw/tongue to side opposite lesion |
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Midline tumor mass in caudal hypothalamus |
Mammillothalamic tracts = decreased ability to form new memories Posterior hypothalamic = hypothermia/poikilothermia; decreased alertness and sometimes somnolence |
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Tumor in midline of hypothalamus approximately halfway through its rostrocaudal extent (rostral thalamus/mid hypothalamus) |
Midline lesion of medial hypothalamus midway through rostrocaudal extent = hyperphagia and obesity, altered endocrine function, enhanced aggressive behavior |
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Pituitary tumor herniated out of the sella turcica and pressing on base of anterior hypothalamus |
Optic chiasm = bitemporal heteronymous hemianopsia |
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Midline tumor in the anterior hypothalamus |
Anterior hypothalamic nuclei including: Supraoptic/paraventricular nuclei = diabetes insipidus Anterior area = hyperthermia (dysfunctional heat dissipation mechanism) Suprachiasmatic nuclei = endocrine dysfunction (inability to regulate circadian rhythm) Fornix = decreased ability to form new memories |
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Thrombosis of branch of middle cerebral a. (left cerebral hemisphere) |
Pars opercularis and triangularis of frontal gyrus (Broca's speech Brodmann's area 44) = motor (expressive, non-fluent) aphasia; often accompanied by agraphia; full speech comprehension with production of single words in telegraphic manner Inferior portion of precentral gyrus = contra lower facial paralysis, contra upper limb paralysis if lesion extends more dorsally into precentral gyrus |
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Thrombosis of branch of middle cerebral a. (left cerebral hemisphere) |
Portions of superior temporal gyrus & inferior supramarginal gyrus (Wernicke's area, Brodmann's areas 22 & 44) = sensory (receptive, fluent) aphasia; often accompanied by dyslexia; patient lacks speech comprehension and puts sounds together into meaningless words and words lacking relation to each other (word salad) |
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Gerstmann's - occurring after a tumor in posterior parietal lobe or thrombosis of branch of middle cerebral a. |
Superior portions of supramarginal and angular gyri (Brodmann's areas 40 & 39) = finger agnosia, right/left confusion, dysgraphia, anomia, acalculia, sometimes dyslexia |
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Tumor mass growing in right inferior parietal lobule; thrombosis of branch of middle cerebral a. |
Portions of supramarginal and angular gyri (Brodmann's areas 40 & 39) = negligence of opposite body half and visual space |
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Thrombosis of branch of posterior cerebral a. (medial hemispheric wall) |
Lingula (Brodmann's area 17) = contralateral homonymous superior quadrantanopsia |
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Meningioma in the falx cerebri growing laterally to affect only one hemisphere |
Paracentral lobule (portions of pre and post central gyri on medial hemispheric wall) = loss of fine touch discrimination, conscious proprioception, and deep pressure sensation over contra lower limb from knee down; inability to localize pain over contra lower limb from knee down; spastic paralysis/paresis of contra leg. |
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Localized (focal) meningioma (left cerebral hemisphere) |
Superior parietal lobule (Brodmann's areas 5 & 7) = asterognosia (inability to recognize shape of objects felt with right hand) |
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Small localized tumor (left cerebral hemisphere) |
Superior frontal gyrus (Brodmann's area 6) = apraxia (patient with no paralysis is unable to carry out complex motor tasks) |
