EXPORT CITATION

Chapter-15 The Brainstem

BOOK TITLE: Neurology

Author
1. Kenkre Rajendra B
ISBN
9788184489477
DOI
10.5005/jp/books/11181_15
Edition
1/e
Publishing Year
2010
Pages
17
Author Affiliations
1. Goa, India
Chapter keywords

Abstract

Various ascending and descending tracts that connect the spinal cord to the different parts of the fore brain pass through the brain stem. Has important autonomic reflex centers associated with the control of respiration and cardiovascular system. It is associated with consciousness. It contains important nuclei of 3rd to 12th cranial nerves MLF is heavily myelinated composite tract found in paramedian plane of the brainstem. Its chief function is to coordinate the movements of the eyes, head, and neck in response to stimulation of the vestibulocochlear nerve. Reticular Formation: It is an illdefined space between cranial nerve nuclei and olives, within ascending and descending tracts of the brainstem and receives sensory input from the spinal cord. Cerebellum and cranial nerve nuclei and sends efferent fibers to these structures. It receives blood supply from basilar artery through its posterior cerebral and superior cerebellar arteries and branches of posterior communicating and anterior choroidal arteries. The vascular syndromes are well defined and could be at mid brain level. Dorsolateral infarction, paramedian infarction, Perinaud’s syndrome, Basal infarction, Medullary- dorsolateral infarction. Locked in syndrome- Bilateral infarction, bilateral 12th nerve lesion. The patient is fully conscious quadriplegic becomes mute and unable to communicate. Transient ischemic attacks—majority of these in the posterior circulation are due to emboli traversing vertebral and basilar arteries. The importance of delineating various vascular syndromes of the brainstem lies in intelligently applying newer imaging modalities to select patients for appropriate surgical procedures such as stenting in vertibrobasilar artery syndromes and evacation of clot in cerebellar hematoma Multiple sclerosis the MLF when affected by demyelination produces signs which are characteristic of multiplesclerosis in presentation of internuclear ophthalmoplegia. Newer imaging modalities MRI PET help in diagnosis of MS and exact localization of the lesion.

© 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved