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STROKE-PARAMEDIAN BRAINSTEM SYNDROMES

Neurology

STROKE-PARAMEDIAN BRAINSTEM SYNDROMES

1. WEBER SYNDROME
- Occlusion of interpeduncular branches of basilar/PCA
- CN III: diplopia
- Corticospinal tract: contralateral hemiparesis

2. MILLARD-GUBLER SYNDROME
- Occlusion of circumferential branches of basilar a.
- CN VI & CN VII: ipsilateral palsy
- Corticospinal tract: contralateral hemiparesis
- Medial lemniscus: contralateral hemi-sensory loss

3. MEDIAL MEDULLARY SYNDROME
- Infraction of the medial medulla due to occlusion of the penetrating branches of the vertebral a./anterior spinal a.
- Ipsilateral CN XII palsy
- Corticospinal tract: contralateral hemiparesis
- Medial lemniscus: contralateral hemi-sensory loss (proprioception & position)




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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: MD, S. (2015). Physical Medicine and Rehabilitation Board Review, Third Edition . 3rd ed. New York: Demos Medical Publishing, p.14.

Ⓒ A. Manickam 2018

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