DR Medhat MRCP

Diseases of brain stem
Lateral pontine syndrome
- e.g Anterior inferior cerebellar artery (AICA) stroke .
• Features :
A. Tracts
Pontine structure
Motor (pyramidal)
Sensory (lateral
spinothalamic tract)
Sympathetic pathway to
head & neck
Lesion in pons i.e above the
level of spinal nucleus of
(V) nerve (in medulla)
Lesion at the level of (V)
motor nucleus
Effect of lesion
Contralateral hemiparesis (UMNL)
Contralateral loss of pain &
temperature sensation (U.L ,LL
,trunk)
Ipsilateral Horner syndrome (with
anhydrosis of face ,arm & trunk)
Ipsilateral loss of pain &
temperature sensation of the face
Ipsilateral weakness of muscles of
mastication (LMNL)
B. Cranial
nerves
(5,7,8)
C. Middle &
inferior
Cerebellar
peduncle
Facial nerve (VII) sensory
nucleus
Facial nerve (VII) autonomic
nucleus
Facial nerve (VII) motor
nucleus
Vestibular nuclei (VIII)
Cochlear nuclei (VIII)
Ipsilateral limb and gait apraxia .
Ipsilateral loss of taste from the
anterior 2/3 of the tongue
Ipsilateral loss of lacrimation and
reduced salivation
loss of the corneal reflex (afferent V
& efferent VII).
Ipsilateral paralysis of the upper and
lower face (LMNL)
Nystagmus, nausea, vomiting,
vertigo
Ipsilateral central deafness
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