Sunday, June 27, 2010

Some brainstem lesions & its manifestation

Lateral Medullary Syndrome is covered already.

Medial Medullary Syndrome/ Dejerine Syndrome

Causes :
Stroke of
-Anterior spinal artery
-Basilar Artery
-Vertebral Artery

Clinical features:
-Contralateral
Pyramidal Tract -> hemiparesis
Medial lemniscus (dorsal column) -> LO concious propioception, LO discriminative touch, LO vibration

-Ipsilateral
Hypogossal nerve -> deviation of tongue to the AFFECTED SIDE (weakness side)

Need help with this, very confusing. If the tongue deviates to the right, meaning the stroke is on right medial medullary ?

Extra : Locked-In Syndrome

Causes :
Stroke in Basilar Artery

Presentations:
-quadriplegia
-cannot speak (vocal cord is not paralysed, but voice and breathing is not coordinated well, hence reduced ability to speak)
-Retain full consciousness & cognitive function
-Eye movement & blinking is still retained -> can be used to communicate

Some call this as "pseudocoma"

by alvis

Thanks to Dr. Ngiu for asking us Wallenburg and thanks to Fadhli for posting that info and stimulate me to find the other brainsteam lesion

Source :
- Netter Neuroanatomy
- Oxford
- Year 2 lecture note
- http://www.strokecenter.org/prof/syndromes/index.htm
(If you guys are intesrested on stroke syndromes, can visit this site)

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