Radiology Board Review
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Axial sections of the brainstem with major nuclei and tracts.
The anatomy of the brainstem is complex. It contains numerous cranial nerve nuclei and is traversed by multiple tracts between the brain and spinal cord. Improved MRI resolution now allows the radiologist to identify a higher level of anatomic detail, but an understanding of functional anatomy is crucial for correct interpretation of disease. Brainstem syndromes are most commonly due to occlusion of the posterior circulation or mass effect from intrinsic space-occupying lesions. These syndromes can have subtle imaging findings that may be missed by a radiologist unfamiliar with the anatomy or typical manifesting features. This article presents the developmental anatomy of the brainstem and discusses associated pathologic syndromes. Congenital and acquired syndromes are described and correlated with anatomic locations at imaging, with diagrams to provide a reference to aid in radiologic interpretation. ©RSNA, 2019
Horner syndrome classically presents as an ipsilateral enophthalmos, blepharoptosis, pupillary miosis and facial anhidrosis due to disruption at some point of the oculosympathetic pathway. Ptosis is due to interruption of the sympathetic motor i...
Brainstem stroke syndromes, also known as crossed brainstem syndromes, refer to a group of syndromes that occur secondary to lesions, most commonly infarcts, of the brainstem. Epidemiology Although many different brainstem stroke syndromes have...
Lateral medullary syndrome, also known as Wallenberg syndrome, is a clinical syndrome caused by acute ischemia or infarction of the lateral medulla oblongata due to occlusion of the intracranial portion of the vertebral artery, PICA or its branch...
- Nausea and vomiting
- Vertigo
- Falling down to the left side
- Ipsilateral horner syndrome
- Ipsilateral sensory loss of the face
- Contralateral sensory loss of the body
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