The document discusses various syndromes associated with lesions in different areas of the brainstem. It describes syndromes related to lesions of the posterior cerebral artery including Dejerine-Roussy syndrome and Claude's syndrome. It also summarizes syndromes caused by lesions in specific areas of the pons such as Millard-Gubler syndrome, Foville syndrome, and locked-in syndrome. Further, it provides details of lateral and medial medullary syndromes. In addition, it includes diagrams of transverse sections of the medulla oblongata, midbrain and descriptions of their blood supply.
Clinical syndromes of vascular disease of the nervousaditya romadhon
The middle cerebral artery is the largest branch of the internal carotid artery and supllies the largest area of the cerebral cortex
Supplying the motor and sensory cortices, also supplies the areas of the cortex pertaining to the comprehension Wernicke’s area and expresion brocca’s area (left hemisphere)
Brain stem - General anatomy, location, anterior and posterior views... Blood vessels in contact with it...
A brief review of the various brain stem structures like we got MOTOR PATHWAY (CORTICOSPINAL TRACT), MEDIAL LEMINISCUS, MEDIAL LONGITUDINAL FASCICULUS, SPINOCEREBELLAR TRACT, SPINOTHALAMIC TRACT..... and there effect of lesion.
We also got here the applied, clinical part discussion in brief related to it.... BRAIN STEM LESIONS, of course...like lateral and medial medullary syndrome, RAYMOND-FOVILLE SYNDROME, MILLARD-GUBLER SYNDROME, CEREBELLO-PONTINE SYNDROME, WEBER’S SYNDROME, ALTERNATING TRIGEMINAL HEMIPLEGIA, BENEDICT’S SYNDROME, PARINAUD’S SYNDROME.... to name a few...
We also discussed about BRAIN DEATH a little.
THANK YOU
Vertebral Artery Pathology
Document by Luc Peeters, MSc.Ost. and Grégoire Lason, MSc.Ost.
Joint principals of the International Academy of Osteopathy (I.A.O.)
More information at www.osteopathy.eu
Gross anatomical description of the medulla with associated significant clinical relevance
Relevant blood supply of the Medulla Oblongata.
Good revision guide
Ocular nerve palsies are tricky to understand and are confusing. Learning the features by correlating with the anatomy make it easy.
These are both congenital and acquired.
With differential diagnosis and by proper stepwise ocular evaluation takes us to final diagnosis.
4th year medical student's seminar presentation under supervision of orthopedic lecturer. Reference is from Dr. Sameh Doss Textbook of upper and lower limb, and also other multiple websites.
Clinical syndromes of vascular disease of the nervousaditya romadhon
The middle cerebral artery is the largest branch of the internal carotid artery and supllies the largest area of the cerebral cortex
Supplying the motor and sensory cortices, also supplies the areas of the cortex pertaining to the comprehension Wernicke’s area and expresion brocca’s area (left hemisphere)
Brain stem - General anatomy, location, anterior and posterior views... Blood vessels in contact with it...
A brief review of the various brain stem structures like we got MOTOR PATHWAY (CORTICOSPINAL TRACT), MEDIAL LEMINISCUS, MEDIAL LONGITUDINAL FASCICULUS, SPINOCEREBELLAR TRACT, SPINOTHALAMIC TRACT..... and there effect of lesion.
We also got here the applied, clinical part discussion in brief related to it.... BRAIN STEM LESIONS, of course...like lateral and medial medullary syndrome, RAYMOND-FOVILLE SYNDROME, MILLARD-GUBLER SYNDROME, CEREBELLO-PONTINE SYNDROME, WEBER’S SYNDROME, ALTERNATING TRIGEMINAL HEMIPLEGIA, BENEDICT’S SYNDROME, PARINAUD’S SYNDROME.... to name a few...
We also discussed about BRAIN DEATH a little.
THANK YOU
Vertebral Artery Pathology
Document by Luc Peeters, MSc.Ost. and Grégoire Lason, MSc.Ost.
Joint principals of the International Academy of Osteopathy (I.A.O.)
More information at www.osteopathy.eu
Gross anatomical description of the medulla with associated significant clinical relevance
Relevant blood supply of the Medulla Oblongata.
Good revision guide
Ocular nerve palsies are tricky to understand and are confusing. Learning the features by correlating with the anatomy make it easy.
These are both congenital and acquired.
With differential diagnosis and by proper stepwise ocular evaluation takes us to final diagnosis.
4th year medical student's seminar presentation under supervision of orthopedic lecturer. Reference is from Dr. Sameh Doss Textbook of upper and lower limb, and also other multiple websites.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
13. Millard-Gubler Syndrome
•unilateral lesion of the ventrocaudal pons
•involve the basis pontis and the fascicles of cranial nerves VI
and VII.
•Contralateral hemiplegia (sparing the face) is due to
pyramidal tract involvement.
•Ipsilateral lateral rectus paresis (cranial nerve VI) with
diplopia that is accentuated when the patienT looks towards•
the lesion.
•Ipsilateral peripheral facial paresis (cranial nerve VII).
14. ⦁ A unilateral lesion of the ventral medial pons,
⦁ affects the ipsilateral abducens nerve
fascicles and the corticospinal tract but
spares cranial nerve VII
⦁ also called alternating abducens hemiplegia)
⦁ Ipsilateral lateral rectus paresis (cranial nerve
VI)
⦁ Contralateral hemiplegia, sparing the face,
due to pyramidal tract involvement
15. ⦁ Lesions (especially lacunar infarction)
involving the corticospinal tracts in the basis
pontis may produce a pure motor hemiplegia
with or without facial involvement
⦁ Patients often have severe dysarthria and
dysphagia.
⦁ Bouts of uncontrollable laughter may also
occur
⦁ A combination of dysarthria and a history of
previous transient gait abnormality or vertigo
favor a pontine lesion as the cause of pure
motor hemiparesis rather than a more
common capsular lesion
16. ⦁ Vascular lesions in the basis pontis (especially
lacunar infarction) at the junction of the
upper one-third and lower two-thirds of the
pons may result in dysarthria clumsy hand
syndrome.
⦁ In this syndrome facial weakness and severe
dysarthria and dysphagia occur along with
clumsiness, and paresis of the hand.
⦁ Hyperreflexia and a Babinski's sign may occur
on the same side as the arm paresis, but
sensation is spared.
17. ⦁ A lesion (usually a lacunar infarction) the basis pontis
at the junction of the upper one-third and the lower
two-thirds of the pons may result in the ataxic
hemiparesis (homolateral ataxia and crural paresis)
syndrome.
⦁ In this syndrome hemiparesis that is more severe in
the lower extremity, is associated with ipsilateral
hemiataxia and occasionally dysarthria, nystagmus,
and paresthesias.
⦁ The lesion is located in the contralateral pons.
⦁ The ataxia is unilateral, probably because transverse
fibers originating from the contralateral pontine
nuclei (and projecting to the contralateral
cerebellum) are spared
18. Locked-inSyndrome
⦁ Bilateral ventral pontine lesions
⦁ This syndrome consists of the following signs:
◦ Quadriplegia due to bilateral corticospinal tract
involvement in the basis pontis
◦ Aphonia due to involvement of the corticobulbar
fibers innervating the lower cranial nerve nuclei
◦ Occasional impairment of horizontal eye movements
due to bilateral involvement of the fascicles of cranial
nerve VI
⦁ Because the reticular formation is not injured,
the patient is fully awake.
⦁ The supranuclear ocular motor pathways lie
dorsally and are therefore spared; therefore,
vertical eye movements and blinking are intact
19. ⦁ Foville Syndrome
◦ lesions involving the dorsal pontine tegmentum in the
caudal third of the pons.
◦ Contralateral hemiplegia (with facial sparing) which is
due to interruption of the corticospinal tract.
◦ Ipsilateral peripheral-type facial palsy which is due to
involvement of the nucleus and fascicle (or both) of
cranial nerve VII.
◦ Inability to move the eyes conjugately to the
ipsilateral side due to involvement of the PPRF or
abducens nucleus, or both
20. ⦁ rostral lesions of the dorsal pons.
⦁ Cerebellar signs (ataxia) with a coarse tremor
which is due to the involvement of the
cerebellum.
⦁ Contralateral hypesthesia with reduction of all
sensory modalities (face and extremities) which
is due to the involvement of the medial
lemniscus and the spinothalamic tract.
⦁ With ventral extension, there may be
contralateral hemiparesis (due to corticospinal
tract involvement) or paralysis of conjugate
gaze toward the side of the lesion (due to
involvement of the PPRF).
21. ⦁ Unilateral mediobasal infarcts.
⦁ severe facio-brachio-crural hemiparesis,
dysarthria, and homolateral or bilateral ataxia.
⦁ Presentations include dysarthria Clumsy hand
syndrome, ataxic hemiparesis with prominent
sensory or
hemiparesis
eye movement disorders, and
with contralateral facial or
abducens palsy.
22. ⦁ Unilateral mediobasal infarcts. These patients
have pseudobulbar palsy and bilateral
sensorimotor disturbances.
⦁ The most common etiology for paramedian
pontine infarcts is small vessel disease;
⦁ vertebrobasilar large vessel disease and
cardiac embolism are less common causes.
23. ⦁ Marie-Foix Syndrome
◦ lateral pontine lesions
◦ affecting the brachium pontis
⦁ Ipsilateral cerebellar ataxia due to
involvement of cerebellar connections
⦁ Contralateral hemiparesis due to involvement
of the corticospinal tract
⦁ Variable contralateral hemihypesthesia for
pain and temperature due to involvement of
the spinothalamic tract
24. ⦁ combined right superior cerebellar artery
occlusion resulting in lateral superior pontine
infarction and
⦁ left posterior inferior cerebellar artery occlusion,
resulting in a left Wallenberg lateral medullary
syndrome
⦁ loss of pain and temperature sensation, whereas
light touch, vibration, position, and deep pain
sensation were preserved (dissociated sensory
loss).
⦁ This interesting lesson in localization was due to
bilateral discrete interruption of spinothalamic
fibers and the spinal nucleus and tract of the
trigeminal nerve.
35. Medulla Oblongata
Gross appearnse:
- Connect the pons sup to spinal cord inf
- About 2.5 cm in length
- The junction of the medulla and spinal cord is at the origin of
the anterior and posterior roots of the first cervical spinal
nerve at level of foramen magnum
- - It is conical in shape
- - central canal
- - cavity of fourth ventricle
- Anteriorly:
- - ant median fissure
- - pyramid
- - decussation of the pyramids
- - Posterolateral to the pyramids are the olives
- Posteriorly:
- - sup is the floor 4th ventricle
- - inf the median sulcus
- - gracile tubercle and lat to it the cuneate tubercle
36. The internal structure of the medulla oblongata is
considered at four levels:
1) level of decussation of pyramids
2) level of decussation of lemnisci
3) level of the olives
4) level just inferior to the pons.
37. Transverse section of the medulla oblongata
at the level of decussation of the pyramids
38. Transverse section of the medulla oblongata at
the level of decussation of the medial lemnisci
39. Transverse section of the medulla oblongata at
the level of the middle of the olivary nuclei
40. Blood supply of Medulla oblongata:
1)ventrally: branches from vertebral and basilar
arteries, Also branches from ant spinal artery
artery
2) dorsolaterally: by post inf cerebellar artery
- Venous drainage:
-1)ventrally: basilar venous plexus
and inf petrosal sinus
2) Dorsally and dorsolaterally to occipital sinus
3)Medullary veins communicate with sinuses and
spinal veins
41. Lateral Medullary Synd:
Wallenberg’s synd
On the side of lesion
V, VII, VIII, IX, X CN &
desc. sympathetic tract
On the opp side
Impaired pain &thermal
sense over half of the
body
42. Medial Medullary Synd
On the side of lesion
Paralysis with atrophy of half of the
tongue
On the opp side
Paralysis of arm and leg sparing face
Impaired tactile & proprioceptive sense
over half of the body
43.
44. Transverse section of the midbrain through the inferior
colliculi shows the division of the midbrain into the
tectum and the cerebral peduncles. Note that the
cerebral peduncles are subdivided by the substantia
nigra into the tegmentum and the crus cerebri
45. Transverse sections of the midbrain. A: At the level of the
inferior colliculus. B: At the level of the superior
colliculus. Note that trochlear nerves completely
decussate within the superior medullary velum