Stroke Syndromes - CRASH! Medical Review Series
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9 سال پیش
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This video has been updated
This video has been updated and condensed: Stroke Syndromes (updated 2023) - CRA...
REVISION (23:00): In classical Benedikt's syndrome, there is no contralateral hemiplegia as a defining feature - unlike in Weber's syndrome. However, in practice, when there is Benedikt's syndrome, there is usually damage to surrounding structures - which would cause some degree of contralateral weakness similar to Weber's syndrome. Some sources include contralateral hemiplegia as part of Benedikt's syndrome, but this wasn't the way Benedikt described it (keep in mind he was primarily working with patients with tuberculomas and syphilitic gummas as the brain lesions, as was common in his era). Benedikt didn't describe his syndrome on stroke patients - in which the damage is vascular/ischemic and much more heterogenous in presentation and able to affect other regions to varying degrees.
CLARIFICATION (13:17): MCA stroke causes deviation towards the side of the lesion because it affects the (ipsilateral) frontal eye field which, in turn, interferes with input to the contralateral CN VI and the ipsilateral CN III (via MLF). The result is reduced tone to the contralateral lateral rectus and the ipsilateral medial rectus, resulting in ipsilateral deviation (towards the lesion). For a more detailed explanation of how this pathway works, see the Neuro-Ophthalmology lecture here: Neuro-opthalmology - CRASH! Medical R....
(Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnosis of any illness. If you think you may be suffering from any medical condition, you should consult your physician or seek immediate medical attention.)
REVISION (23:00): In classical Benedikt's syndrome, there is no contralateral hemiplegia as a defining feature - unlike in Weber's syndrome. However, in practice, when there is Benedikt's syndrome, there is usually damage to surrounding structures - which would cause some degree of contralateral weakness similar to Weber's syndrome. Some sources include contralateral hemiplegia as part of Benedikt's syndrome, but this wasn't the way Benedikt described it (keep in mind he was primarily working with patients with tuberculomas and syphilitic gummas as the brain lesions, as was common in his era). Benedikt didn't describe his syndrome on stroke patients - in which the damage is vascular/ischemic and much more heterogenous in presentation and able to affect other regions to varying degrees.
CLARIFICATION (13:17): MCA stroke causes deviation towards the side of the lesion because it affects the (ipsilateral) frontal eye field which, in turn, interferes with input to the contralateral CN VI and the ipsilateral CN III (via MLF). The result is reduced tone to the contralateral lateral rectus and the ipsilateral medial rectus, resulting in ipsilateral deviation (towards the lesion). For a more detailed explanation of how this pathway works, see the Neuro-Ophthalmology lecture here: Neuro-opthalmology - CRASH! Medical R....
(Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnosis of any illness. If you think you may be suffering from any medical condition, you should consult your physician or seek immediate medical attention.)
9 سال پیش
در تاریخ 1394/06/30 منتشر شده
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