Neuro 14 Vascular Syndromes

Front 1

Medial Medulla vascular supply?

Back 1

Paramedian branches of vertebral and anterior spinal arteries

Front 2

Structures affected in medial medullary syndrome?

Back 2

1.Pyramidal tract
2. Medial lemniscus
3. Hypoglossal nucleus and exiting CN XII fascicles

Front 3

Symptoms of medial medullary syndrome

Back 3

1. Contralateral arm or leg weakness (pyramidal tract)
2. Contralateral decreased position/vibration sense (medial lemniscus
3. Ipsilateral tongue weakness (CN XII)

Front 4

Lateral medulla vascular supply?

Back 4

Vertebral artery (sometimes PICA)

Front 5

Wallenberg's syndrome (lateral medullary syndrome) affected structures?

Back 5

1. Inferior cerebellar peduncle, vestibular nuclei
2. Trigeminal nucleus and tract
3. Spinothalamic tract
4. Descending sympathetic fibers
5. Nucleus ambiguus
6. Nucleus solitarius

Front 6

Symptoms of Wallenberg's syndrome?

Back 6

1. Ipsilateral ataxia, vertigo, nystagmus, nausea - Inferior cerebellar peduncle, vestibular nuclei
2. Ipsilateral facial decreased pain and temperature sense - Trigeminal nucleus and tract
3. Contralateral body and decreased pain and temperature sense - Spinothalamic tract
4. Ipsilateral Horner's Syndrome - Descending sympathetic fibers
5. Hoarseness, Dysphagia - Nucleus ambiguus
6. Ipsilateral decreased taste - Nucleus solitarius

Front 7

Vascular supply to midbrain basis?

Back 7

Branches of PCA and top of basilar artery

Front 8

What region is affected in Weber's syndrome? What structures are affected?

Back 8

1. Midbrain basis
2. Oculomotor nerve fascicles, cerebral peduncle

Front 9

Symptoms of Weber's syndrome?

Back 9

Ipsilateral third nerve palsy (oculomotor nerve fascicles)
Contralateral hemiparesis (cerebral peduncle)

Front 10

Area affected in Claude's Syndrome? Affected structures?

Back 10

1. Midbrain tegmentum
2. Oculomotor nerve fascicles, red nucleus, superior cerebellar peduncle fibers

Front 11

Symptoms of Claude's syndrome?

Back 11

Ipsilateral third nerve palsy (oculomotor fascicles)
Contralateral ataxia (red nucleus, sup. cerebellar peduncle fibers)

Front 12

Regions affected in Benedikt's syndrome?

Back 12

Midbrain basis and midbrain tegmentum

Front 13

Vascular supply to midbrain tegmentum?

Back 13

Branches of PCA and top of basilar artery

Front 14

Symptoms of Benedikt's syndrome?

Back 14

1. Ipsilateral third nerve palsy (oculomotor)
2. contralateral hemiparesis (cerbral peduncle)
3. contralateral ataxia, tremor, involuntary movements (red nucleus, substantia nigra, sup. cerebellar penduncle fibers)

Front 15

Structures affected in Benedikt's syndrome?

Back 15

Oculomotor nerve fascicles
Cerebral peduncle
Red nucleus, substantia nigra, superior cerebellar peduncle fibers

Front 16

Structures of medial pontine basis

Back 16

Corticospinal/corticobulbar tracts
Pontine nuclei, pontocerebellar fibers

Front 17

Vascular supply to medial pontine basis

Back 17

Paramedian branches of basilar artery, ventral territory

Front 18

Symptoms of medial pontine basis infarct

Back 18

1. Corticospinal/corticobulbar tracts: Contralateral face, arm, and leg weakness; dysarthria

2. If pontine nuclei, pontocerebellar fibers involved: contralateral ataxia (sometimes ipsilateral)

Front 19

Blood supply to medial pontine basis and tegmentum

Back 19

Paramedian branches of basilar artery, ventral and dorsal territories

Front 20

Structures that could be affected in medial pontine basis and tegmentum

Back 20

1. Corticospinal/corticobulbar tracts (contralateral face, arm, and leg weakness; dysarthria)
2. Facial colliculus (ipsilateral facial weakness; ipsilateral horizontal gaze palsy)
3. Abducens nucleus or paramedian pontine reticular formation (ipsilateral horizontal gaze palsy)
4. Medial lemniscus (contralateral decreased position and vibration sense)
5. Medial longitudinal fasciculus (internuclear opthalmoplegia)
6. Fascicles of facial nerve (ipsilateral facial weakness)

Front 21

Symptoms of medial pontine basis/tegmentum infarct

Back 21

(May involve multiple structures)

Foville's: Corticospinal/corticobulbar + Facial colliculus

Pontine wrong-way eyes: Corticospinal/corticobulbar + fascicles of facial nerve

Millard-Gubler: Corticospinal/corticobulbar + fascicles of facial nerve

Other regions: medial lemniscus

Front 22

Lateral caudal pons vascular supply

Back 22

AICA
(labyrinthine artery may also be affected)

Front 23

Structures involved in lateral caudal pons syndromes?

Back 23

1. Middle cerebellar peduncle - ipsilateral ataxia
2. Vestibular nuclei - vertigo, nystagmus
3. Trigeminal nuclear and tract - ipsilateralfacial decreased pain and temperature sense
4. Spinothalamic tract - contralateral decreased pain and temperature sense
5. Descending sympathetic fibers - ipsilateral Horner's syndrome
6. Inner ear (labyrinthine)

Front 24

Dorsolateral rostral pons blood supply

Back 24

SCA

Front 25

Structures affected in SCA syndrome (dorsolateral rostral pons)? Symptoms?

Back 25

1. Superior cerebellar peduncle and cerebellum - ipsilateral ataxia

2. Other lateral tegmental structures (AICA syndrome like features)