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Medial Medullary Syndrome
Medial medullary syndrome, also known as inferior alternating syndrome, hypoglossal alternating hemiplegia, lower alternating hemiplegia, or Dejerine syndrome, is a type of alternating hemiplegia characterized by a set of clinical features resulting from occlusion of the anterior spinal artery. This results in the infarction of medial part of the medulla oblongata. Presentation The condition usually consists of: Sensation to the face is preserved, due to the sparing of the trigeminal nucleus. The syndrome is said to be "alternating" because the lesion causes symptoms both contralaterally and ipsilaterally. Sensation of pain and temperature is preserved, because the spinothalamic tract is located more laterally in the brainstem and is also not supplied by the anterior spinal artery (instead supplied by the posterior inferior cerebellar arteries and the vertebral arteries). Pathophysiology The anterior spinal artery arises bilaterally as two small branches near the termination ...
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Medulla Oblongata
The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (involuntary) functions, ranging from vomiting to sneezing. The medulla contains the cardiac, respiratory, vomiting and vasomotor centers, and therefore deals with the autonomic functions of breathing, heart rate and blood pressure as well as the sleep–wake cycle. During embryonic development, the medulla oblongata develops from the myelencephalon. The myelencephalon is a secondary vesicle which forms during the maturation of the rhombencephalon, also referred to as the hindbrain. The bulb is an archaic term for the medulla oblongata. In modern clinical usage, the word bulbar (as in bulbar palsy) is retained for terms that relate to the medulla oblongata, particularly in reference to medical conditions. The word bulbar can refer to the nerves ...
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Spinothalamic Tract
The spinothalamic tract is a part of the anterolateral system or the ventrolateral system, a sensory pathway to the thalamus. From the ventral posterolateral nucleus in the thalamus, sensory information is relayed upward to the somatosensory cortex of the postcentral gyrus. The spinothalamic tract consists of two adjacent pathways: anterior and lateral. The anterior spinothalamic tract carries information about crude touch. The lateral spinothalamic tract conveys pain and temperature. In the spinal cord, the spinothalamic tract has somatotopic arrangement, somatotopic organization. This is the segmental organization of its Neck, cervical, thoracic, lumbar, and Sacrum, sacral components, which is arranged from most medial to most lateral respectively. The pathway crosses over (decussates) at the level of the spinal cord, rather than in the brainstem like the dorsal column-medial lemniscus pathway and lateral corticospinal tract. It is one of the three tracts which make up the an ...
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Medial Pontine Syndrome
Medial inferior pontine syndrome is a condition associated with a contralateral hemiplegia."Medial inferior pontine syndrome" has been described as equivalent to Foville's syndrome. Presentation Although medial pontine syndrome has many similarities to medial medullary syndrome, because it is located higher up the brainstem in the pons, it affects a different set of cranial nuclei. Depending upon the size of the infarct, it can also involve the facial nerve. Cause Medial pontine syndrome results from occlusion of paramedian branches of the basilar artery. Diagnosis Treatment See also * Alternating hemiplegia of childhood * Lateral medullary syndrome * Lateral pontine syndrome * Medial medullary syndrome * Weber's syndrome Weber's syndrome, also known as midbrain stroke syndrome or superior alternating hemiplegia, is a form of stroke that affects the medial portion of the midbrain. It involves oculomotor fascicles in the interpeduncular cisterns and cerebral peduncl . ...
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Lateral Pontine Syndrome
A lateral pontine syndrome is a lesion which is similar to the lateral medullary syndrome, but because it occurs in the pons, it also involves the cranial nerve nuclei of the pons. Symptoms Damage to the following areas produces symptoms (from medial to lateral): Causes It can be caused by an interruption to the blood supply of the anterior inferior cerebellar artery The anterior inferior cerebellar artery (AICA) is one of three pairs of arteries that supplies blood to the cerebellum. It arises from the basilar artery on each side at the level of the junction between the medulla oblongata and the pons in the ... or circumferential arteries. Treatment References External links Stroke Syndromes affecting the nervous system {{nervoussystem-disease-stub ...
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Lateral Medullary Syndrome
Lateral medullary syndrome is a neurological disorder causing a range of symptoms due to ischemia in the lateral part of the medulla oblongata in the brainstem. The ischemia is a result of a blockage most commonly in the vertebral artery or the posterior inferior cerebellar artery. Lateral medullary syndrome is also called Wallenberg's syndrome, posterior inferior cerebellar artery (PICA) syndrome and vertebral artery syndrome. Signs and symptoms This syndrome is characterized by sensory deficits that affect the trunk and extremities contralaterally (opposite to the lesion), and sensory deficits of the face and cranial nerves ipsilaterally (same side as the lesion). Specifically a loss of pain and temperature sensation if the lateral spinothalamic tract is involved. The cross body finding is the chief symptom from which a diagnosis can be made. Patients often have difficulty walking or maintaining balance (ataxia), or difference in temperature of an object based on which side of ...
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Alternating Hemiplegia Of Childhood
Alternating hemiplegia of childhood (AHC) is an ultra-rare neurological disorder named for the transient episodes, often referred to as "attacks", of hemiplegia (weakness or paralysis) from which those with the disorder suffer. It typically presents before the age of 18 months. These hemiplegic attacks can cause anything from mild weakness to complete paralysis on one or both sides of the body, and they can vary greatly in duration. Attacks may also alternate from one side of the body to the other, or alternate between affecting one or both sides during a single attack. Besides hemiplegia, symptoms of the disorder include an extremely broad range of neurological and developmental impairments which are not well understood. Normally, hemiplegia and other associated symptoms cease completely with sleep, but they may recur upon waking. Most frequently AHC is caused by a spontaneous mutation in the ''ATP1A3'' gene.2. It is an extremely rare disorder – approximately 1 in 1,000,000 peopl ...
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Pons
The pons (from Latin , "bridge") is part of the brainstem that in humans and other bipeds lies inferior to the midbrain, superior to the medulla oblongata and anterior to the cerebellum. The pons is also called the pons Varolii ("bridge of Varolius"), after the Italian anatomist and surgeon Costanzo Varolio (1543–75). This region of the brainstem includes neural pathways and tracts that conduct signals from the brain down to the cerebellum and medulla, and tracts that carry the sensory signals up into the thalamus.Saladin Kenneth S.(2007) Anatomy & physiology the unity of form and function. Dubuque, IA: McGraw-Hill Structure The pons is in the brainstem situated between the midbrain and the medulla oblongata, and in front of the cerebellum. A separating groove between the pons and the medulla is the inferior pontine sulcus. The superior pontine sulcus separates the pons from the midbrain. The pons can be broadly divided into two parts: the basilar part of the pons (ventral ...
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Trigeminal Nucleus
The sensory trigeminal nerve nuclei are the largest of the cranial nerve nuclei, and extend through the whole of the midbrain, pons and medulla, and into the high cervical spinal cord. The nucleus is divided into three parts, from rostral to caudal (top to bottom in humans): * The mesencephalic nucleus * The chief sensory nucleus (or "pontine nucleus" or "main sensory nucleus" or "primary nucleus" or "principal nucleus") * The spinal trigeminal nucleus ::The spinal trigeminal nucleus is further subdivided into three parts, from rostral to caudal: :* Pars Oralis (from the Pons to the Hypoglossal nucleus) :* Pars Interpolaris (from the Hypoglossal nucleus to the obex) :* Pars Caudalis (from the obex to C2) There is also a distinct trigeminal motor nucleus that is medial to the chief sensory nucleus. See also * Photic sneeze reflex * Trigeminal nerve In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or ...
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Posterior Inferior Cerebellar Artery
The posterior inferior cerebellar artery (PICA) is the largest branch of the vertebral artery. It is one of the three main arteries that supply blood to the cerebellum, a part of the brain. Blockage of the posterior inferior cerebellar artery can result in a type of stroke called lateral medullary syndrome. Course It winds backward around the upper part of the medulla oblongata, passing between the origins of the vagus nerve and the accessory nerve, over the inferior cerebellar peduncle to the undersurface of the cerebellum, where it divides into two branches. The medial branch continues backward to the notch between the two hemispheres of the cerebellum; while the lateral supplies the under surface of the cerebellum, as far as its lateral border, where it anastomoses with the anterior inferior cerebellar and the superior cerebellar branches of the basilar artery. Branches from this artery supply the choroid plexus of the fourth ventricle. Clinical significance A disrupted blo ...
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Vertebral Artery
The vertebral arteries are major arteries An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pu ... of the neck. Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, midline basilar artery. As the supplying component of the ''vertebrobasilar vascular system'', the vertebral arteries supply blood to the upper spinal cord, brainstem, cerebellum, and Cerebral circulation#Posterior cerebral circulation, posterior part of brain. Structure The vertebral arteries usually arise from the posterosuperior aspect of the central subclavian arteries on each side of the body, then enter deep to the transverse process at the level of the 6th cervical vertebrae (C6), or occasio ...
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Medial Lemniscus
In neuroanatomy, the medial lemniscus, also known as Reil's band or Reil's ribbon (for German anatomist Johann Christian Reil), is a large ascending bundle of heavily myelinated axons that decussate (cross) in the brainstem, specifically in the medulla oblongata. The medial lemniscus is formed by the crossings of the internal arcuate fibers. The internal arcuate fibers are composed of axons of nucleus gracilis and nucleus cuneatus. The axons of the nucleus gracilis and nucleus cuneatus in the medial lemniscus have cell bodies that lie contralaterally. The medial lemniscus is part of the dorsal column–medial lemniscus pathway, which ascends from the skin to the thalamus, which is important for somatosensation from the skin and joints, therefore, lesion of the medial lemnisci causes an impairment of vibratory and touch-pressure sense. Etymology Lemniscus means "ribbon", so named because the medial lemniscus "spirals" or "turns" as it ascends. Path After neurons carrying propri ...
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Human Brainstem Blood Supply Description
Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, and language. Humans are highly social and tend to live in complex social structures composed of many cooperating and competing groups, from families and kinship networks to political states. Social interactions between humans have established a wide variety of values, social norms, and rituals, which bolster human society. Its intelligence and its desire to understand and influence the environment and to explain and manipulate phenomena have motivated humanity's development of science, philosophy, mythology, religion, and other fields of study. Although some scientists equate the term ''humans'' with all members of the genus ''Homo'', in common usage, it generally refers to ''Homo sapiens'', the only extant member. Anatomically modern huma ...
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