tailieunhanh - PRINCIPLES OF NEUROLOGY - PART 9

Supranuclear cơ chế nhìn lên trên và các cấu trúc khác bại periaqueductal chất xám làm mắt vận động dấu hiệu bị bại liệt nửa người làm mắt vận động vượt qua bên đối diện với thất điều tiểu não và bại làm mắt vận động run với thất điều tiểu não bên đối diện, run | 444 TABLE 46-2 Intrinsic Brainstem Syndromes Involving Cranial Nerves Eopnymic syndrome Site Cranial nerves involved Tracts and nuclei involved Signs Usual causes Weber Base of midbrain III Corticospinal tract Oculomotor palsy with crossed hemiplegia Infarction tumor Claude Tegmentum of midbrain III Red nucleus and brachium conjunctivum Oculomotor palsy with contralateral cerebellar ataxia and tremor Infarction tumor Benedikt Tegmentum of midbrain III Red nucleus corticospinal tract and brachium conjunctivum Oculomotor palsy with contralateral cerebellar ataxia tremor and corticospinal signs Infarction hemorrhage tumor Nothnagel Tectum of midbrain Unilateral or bilateral III Superior cerebellar peduncles Ocular palsies paralysis of gaze and cerebellar ataxia Tumor infarction Parinaud Dorsal midbrain Supranuclear mechanism for upward gaze and other structures in periaqueductal gray Paralysis of upward gaze and accommodation fixed pupils Pinealoma hydrocephalus and other lesions of dorsal midbrain matter 445 Millard-Gubler and Raymond-Foville Avellis Jackson Wallenberg Tegmentum and base of pons Tegmentum of medulla Tegmentum of medulla Lateral tegmentum of medulla VII and often VI X X XII Spinal V IX X Corticospinal tract Spinothalamic tract sometimes descending sympathetic fibers with Horner syndrome Corticospinal tract Vestibular nuclei lateral spinothalamic tract descending pupillodilator fibers Spinocerebellar and olivocerebellar tracts medial longitudinal fasciculus Facial and abducens palsy and contralateral hemiplegia sometimes gaze palsy to side of lesion Paralysis of soft palate and vocal cord and contralateral hemianesthesia Avellis syndrome plus ipsilateral tongue paralysis Nystagmus ipsilateral V IX X XI palsy Horner syndrome and cerebellar ataxia contralateral loss of pain and temperature sense ipsilateral central facial analgesia INO Infarction or tumor Infarction or tumor Infarction or tumor Occlusion of vertebral or posteroinferior cerebellar artery