I. Common syndromes of the midbrain
1. weber syndrome (Weber syndrome): The lesion is located in the ventral part of the cerebral peduncle of the midbrain, damaging the pyramidal tract and the motoneurotic nerve. Crossed paralysis occurs. Performance.
Ipsilateral: paralysis of the oculomotor nerve.
Contralateral: hemiparesis (including central facial palsy and lingual palsy)
Common causes: temporal lobe tumor, subdural hematoma with associated canopy herniation compressing the cerebral peduncle (especially hook gyrus herniation caused by temporal lobe tumor or hematoma), skull base aneurysm.
2. Benedit syndrome (Benedict’s syndrome): the lesion is located in the red nucleus and substantia nigra behind the cerebral peduncle of the midbrain. Because the nerve fibers of the nerve root penetrate the medial part of the substantia nigra, the nigrostriatal lesion often involves the ipsilateral nerve of the nerve. Manifestations.
Ipsilateral: Actinic nerve palsy.
Contralateral: Extrapyramidal symptoms such as eccentric chorea, eccentric tardive dyskinesia and eccentric tremor and increased muscle tone similar to Parkinson’s syndrome.
Common causes: local inflammation, trauma, etc.
Claude syndrome (Claude syndrome): The lesion is located in the midbrain perineurium, close to the midbrain aqueduct, and damages the red nucleus (red nucleus reticularis spinalis), because the root fibers of the nerve penetrate the red nucleus, so the red nucleus lesion often involves the ipsilateral nerve. Presentation.
Ipsilateral: paralysis of the oculomotor nerve.
Contralateral: partial ataxia.
Common causes: local inflammation, tumor, trauma.
4, Parinaud syndrome (Parinoid syndrome): the lesion is located in the parietal part of the midbrain (tetralogy of Fallot) that is, tetralogy of Fallot syndrome.
Performance: The superior colliculus is often damaged in the following three ways: (1) both eyes are paralyzed in upward vision. (2) Upward and downward paralysis of both eyes. (3) Bilateral paralysis of inferior vision.
Common causes: pineal tumors, tumors of the tetrasegmental and cerebellar earthworms, local inflammation and vascular lesions.
Common syndromes of the pontine brain
1.Fovil syndrome (Fovil syndrome): The lesion is located in the medial part of the pontine base, near the midline. Damage to the abducens nerve and its supranuclear nerve pathway, the medial longitudinal bundle; and damage to the pyramidal bundle. Presentation.
Ipsilateral: abducens nerve palsy, inability to abduct the eye (isotropic gaze palsy of both eyes to the side of the lesion), mild rotation of the head to the contralateral side of the lesion (medial longitudinal bundle).
Contralateral: central hemiparesis (pyramidal tract), sensory deficits (medial thalamic tract).
Common etiologies: mostly vascular disease, followed by inflammation, tumors, demyelination.
2. Millard-Gubler syndrome (Miani-Gubler syndrome): the lesion is located in the basolateral part of the pontine brain. Injury to the abducens nerve and facial nerve or its nucleus; and injury to the pyramidal tract. Presentation.
Ipsilateral: inability to abduct the eye (abducens nerve), peripheral facial palsy (facial nerve).
Contralateral: hemiparesis of the limbs.
Common causes: inflammation, tumor, demyelination common.
3. Raymond-Cestan syndrome (Raymond-Cestan): the lesion is located in the dorsal part of the pontocerebral perineurium, adjacent to the base of the fourth ventricle. Manifestations.
Ipsilateral: cerebellar ataxia (combined arm), facial sensory disturbance (trigeminal nerve), bilateral gaze palsy to the side of the lesion (abducens nerve and medial longitudinal bundle).
Contralateral: hemiplegic dissociative sensory disorder (spinal thalamic tract).
Etiology: may be occlusion of the superior cerebellar artery, tumor of the dorsal cap of the pontine brain.