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Neuro 3.28 Brain Lesions

Terms in this set (89)

ventral white commissure (sensory)

pain & temperature
- upper limb dermatomes
- cape-like distribution

bilateral
A
fasciculus gracilis and cuneatus (sensory)

touch and conscious properioception
- upper and lower limbs

ipsilateral
A-B
Lissauer's tract (sensory)

pain at levels affected

ipsilateral
C
dorsal horn (sensory)

touch at levels affected

ipsilateral
D
lateral CST (motor)

some hemiplegia at and below level
- upper and/or lower limbs

ipsilateral
E
fasciculus gracilis (sensory)

some touch and conscious proprioception
- lower limb

bilateral
A
ventral white commissure (sensory)

pain and temperature
- at levels affected

bilateral
B
+/- ALS (sensory)

pain and temperature
- below levels

bilateral
C
+/- lateral corticospinal fibers (motor)

spastic hemiplegia of limbs below

bilateral
D
anterior corticospinal fibers (motor)

spastic hemiplegia of axial muscles below

bilateral
E
ventral horn (motor)

flaccid paralysis of mm. at levels affected

bilateral
F
fasciculus gracilis and cuneatus (sensory)

touch and conscious proprioception
- upper and lower limbs

ipsilateral
A-B
ALS - spinothalamic tracts (sensory)

pain and temperature below lesion

contralateral
C
spinocerebellar tracts (sensory)

unconscious proprioception

ipsilateral
D-E
lateral corticospinal fibers and rubrospinal fibers (motor)

spastic hemiplegia of UE and LE below lesion

ipsilateral
F
ventral corticospinal fibers (motor)

spastic hemiplegia, axial mm. below

bilateral
G
ventral horn

flaccid paralysis of mm. at level

ipsilateral
H
medial lemniscus (sensory)

touch and conscious proprioception
- UE and LE

contralateral
A
corticospinal fibers (pyramid) (motor)

spastic hemiplegia of upper and lower limbs

contralateral
B
hypoglossal nucleus (motor)

hemilingual muscle palsy; deviation to lesion side on protrusion

ipsilateral
C
corticospinal fibers + hypoglossal nucleus (motor)

alternating hemiplegia

ipsi- tongue; contra- limbs
B + C
spinal trigeminal tract and nucleus (sensory)

pain and temperature (face)

ipsilateral
A
vestibular nuclei (sensory)

vertigo (spinning), nystagmus, fall to same side

ipsilateral
B
ALS (sensory)

pain and temperature (body)

contralateral
C
solitary nucleus (sensory)

loss of taste

ipsilateral
D
hypothalamospinal sympathetics (motor)

Horner's syndrome

ipsilateral
E
ICP - spinocerebellar fibers (motor)

ataxia

ipsilateral
F
nucleus ambiguus (motor)

palatopharyngeal paralysis (dysphagia), dysarthria, no gag reflex

ipsilateral
G
spinal trigeminal tract/nucleus + ALS (motor)

alternating hemianalgesia

ipsi- / contra-
A + C
respiratory and cardioregulatory centers

respiratory and cardiac dysregulation
fatality

bilateral
A
medial lemniscus (sensory)

touch and conscious proprioception

contralateral
A
corticospinal tract (motor)

hemiplegia of upper & lower limbs

contralateral
B
abducens nucleus and/or fibers (motor)

lateral rectus palsy

ipsilateral
C
facial nerve fibers (motor)

facial paralysis

ipsilateral
D
paramedian pontine reticular formation (PPRF) (motor)

conjugate paralysis to side of lesion

ipsilateral
E
cortical spinal tract + abducens nucleus (motor)

middle alternating hemiplegia

contra- / ipsi-
B + C
corticospinal tract (motor)

hemiplegia of upper & lower limbs

contralateral
B
abducens intrabulbar fibers (motor)

lateral rectus palsy

ipsilateral
C
facial nerve fibers (motor)

facial paralysis

ipsilateral
D
ALS (sensory)

hemianalgesia limbs & trunk

contralateral
A
ventral trigeminothalamic tract (sensory)

face analgesia

contralateral
B
trigeminal chief sensory nucleus (sensory)

face anesthesia

ipsilateral
C
+/- medial lemniscus

lower limb hemianesthesia

contralateral
D
trigeminal motor nucleus (motor)

masticatory paresis/paralysis

ipsilateral
E
MCP, SCP (motor)

limb ataxias

ipsilateral
F
corticospinal fibers (motor) / hypothalamospinal tract (autonomic)

limb paresis & paralysis / Horner's

contralateral / ipsilateral
G
corticospinal fibers (motor)

quadriplegia; can include: masticatory palsy, gaze palsys, laryngeal palsy (aphonia; mute), facial palsy, dysphagia (can't initiate swallowing)

bilateral
A
posterior spinocerebellum, vestibulocerebellum (nodulus) (motor)

vestibular problems: nystagmus, spinning, falling to same side; truncal ataxia

ipsilateral
A
trochlear nuc. or fibers; MLF (motor)

superior oblique paralysis + internuclear ophthalmoplegia

contralateral
A
superior cerebellar decussation (motor)

ataxia

bilateral
B
minimal CST involvement

minor hemiplegia

contralateral
C
trochlear nuc. or fibers; MLF (motor)

superior oblique paralysis + internuclear ophthalmoplegia

contralateral
A
superior cerebellar decussation (motor)

ataxia

bilateral
B
oculomotor nuc. or fibers; MLF (motor)

eye movement paralyses

ipsilateral
A
Edinger-Westphal (motor)

autonomic eye reflexes (pupillary, ciliary)

ipsilateral
B
superior cerebellar peduncle decussation (motor)

ataxia

bilateral
C
red nucleus, rubrospinal decussation (motor)

proximal limb flexors

bilateral
D
oculomotor fibers (motor)

eye movement paralyses (eye down & out)

ipsilateral
A
CST (motor)

limbs and trunk hemiplegia

contralateral
B
CNT (motor)

hemiplegias (lower VII, X, XII)

contralateral
C
substantia nigra

parkinsonism

contralateral
D
oculomotor fibers / CST (motor)

alternating hemiplegia

ipsi- / contra-
A + B
oculomotor nuc. or fibers (motor)

eye movement paralyses

ipsilateral
A
superior cerebellar peduncle decussation (motor)

cerebro(ponto)cerebellar ataxias (skilled)

contralateral
B
+/- red nucleus (motor)

proximal limb flexors

bilateral
C
CST, CNT (motor)

hemiplegia

contralateral
D
oculomotor fibers / SCP decussation (motor)

eye movement paralyses / cerebrocerebellar ataxias (skilled)

ipsi- / contra- (cerebellar fibers already crossed)
A + B
pretectal nucs. & post. commissure (motor)

autonomic eye reflexes (consensual)

bilateral
A
superior colliculus (motor)

voluntary saccades and tracking

bilateral
B
vertical gaze center (motor)

initially, conjugate upward gaze paralysis, later + downward (i.e., both)

bilateral
C
CN III compression / crus cerebri compression / rostral reticular formation

pupillary dilation and oculomotor weakness / hemiparesis / drowsiness, LOC, respiratory dysregulation

ipsi- / contra- / na
A + B + C
posterior paracentral lobule and superiormost postcentral gyrus (sensory)

lower limb anesthesia

contralateral
A
anterior paracentral lobule and superiormost precentral gyrus (motor)

lower limb paralysis

contralateral
B
micturation center

reduced voluntary inhibition of bladder emptying

bladder empties as a unit
C
olfactory tract

anosmia

ipsilateral
D
corpus callosum

disconnection syndromes

bilateral
E
medial occipital cortex; +/- pole (sensory)

homonymous hemianopia +/- macular sparing
A
thalamus (sensory)

thalamic syndromes
B
hippocampal region

memory
C
central & lower postcentral gyrus (sensory)

anesthesia of upper limb & face

contralateral
A
insula + operculum

loss of taste

ipsilateral
B
angular gyrus (sensory)

writing; reading out loud, calculation

contralateral
C
central and lower precentral gyrus (motor)

paralysis of upper limb and lower face

contralateral
D
Broca's area (dominant side) (motor)

impaired language expression (aphasia)
E
Wernicke's area (dominant side) (sensory)

receptive aphasia (impaired comprehension; speech fluent but nonsensical)
A
Meyer's loop (rostral geniculocalcarine tract) (sensory)

homonymous upper quadrantanopia
B
+/- occipital pole (variable) (sensory)

+/- macular vision
C
genu and PLIC (sensory + motor)

hemiplegia: lower face & upper limb (superior div.) + lower limb

hemianesthesia: face & upper limb (super. div.) + lower limb

contralateral
A
lenticular nucleus

basal nuclear motor effects masked by paralyses
B
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