Weber's syndrome, also known as midbrain stroke syndrome or superior alternating hemiplegia, is a form of

stroke A stroke is a disease, medical condition in which poor cerebral circulation, blood flow to the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemorr ...

that affects the medial portion of the midbrain. It involves oculomotor fascicles in the interpeduncular cisterns and cerebral peduncle so it characterizes the presence of an ipsilateral lower motor neuron type oculomotor nerve palsy and contralateral

hemiparesis Hemiparesis, or unilateral paresis, is weakness of one entire side of the body ('' hemi-'' means "half"). Hemiplegia is, in its most severe form, complete paralysis of half of the body. Hemiparesis and hemiplegia can be caused by different med ...

or hemiplegia.

Cause

It is mainly caused by a

midbrain The midbrain or mesencephalon is the forward-most portion of the brainstem and is associated with vision, hearing, motor control, sleep and wakefulness, arousal ( alertness), and temperature regulation. The name comes from the Greek ''mesos'', ...

infarction Infarction is tissue death ( necrosis) due to inadequate blood supply to the affected area. It may be caused by artery blockages, rupture, mechanical compression, or vasoconstriction. The resulting lesion is referred to as an infarct (from th ...

as a result of occlusion of a branch of posterior cerebral artery most commonly or the paramedian branches of basilar bifurcation perforating arteries. This lesion is usually unilateral and affects several structures in the midbrain including:

Diagnosis

Clinical findings mainly eyeball is down and out ipsilateral lateral squint. Ptosis present as the levator palpebrae superioris nerve supply is disrupted. Pupil dilated and fixed. Contralateral hemiplegia CT scan or MRI might help in delineating the cause or the vessel or region of brain involved in stroke.

Management

History

It carries the name of Sir

Hermann David Weber Sir Herman David Weber FRCP (30 December 1823 – 11 November 1918) was a German physician who practiced medicine in England. Biography Weber attended Gymnasium in Fulda in 1838, but started his medical studies at Marburg University in 18 ...

, a German-born physician working in London, who described the condition in 1863. It is unrelated to Sturge–Weber syndrome, Klippel–Trénaunay–Weber syndrome or Osler–Weber–Rendu syndrome. These conditions are named for his son Frederick Parkes Weber.

References

External links