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more neuroanatomy

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8 Posts

01/12/04 - 12:20 PM

A patient presented with sudden hearing loss associated with vomiting and vertigo. Patient was unable to walk properly due to weakness in the right sided lower limbs. Neurological examination showed constriction of pupil in the right eye and a nystagmus in the left eye. Further examination revealed that the patient was drollinng from the right side and there were no sensation of pain on the same side. The patient also complained of loss of pain sensation in the left side of the body. What artery is most probably involved in the lesion?

a) anterior spinal artery
b) right posterior inferior cerebellar artery
c) right anterior inferior cerebellar artery
d) left posterior inf. cereballar artery
e) left anterior inferior cereballar artery
f ) superior cerebellar artery
g) middle meningeal artery

meg
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01/12/04 - 01:17 PM

Rt PICA (Wallenberg)

01/12/04 - 01:28 PM

well, its not rt pica, try again

mjl1717
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01/12/04 - 04:28 PM

left PICA?

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asmi
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01/12/04 - 09:17 PM

D :?:

meg
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01/13/04 - 06:40 AM

I think it is rt AICA. In PICA there wont be deafness.

01/13/04 - 07:27 AM

This is lateral pontine syndrome which is just like lateral medullary syndrome (wallenberg) with the difference that it involves motor fibers of Vll nerve (drooling) and cochlear nucleus of Vlll.

Anerior inferior cerebellar artery supplies lateral aspect of pons.

A left sided artery cannot cause this lesion as the long tracts from left side of the body are involved, so it has to be a right sided lesion.

The key to this kind of questions:
Look for long tract lesions DC, CST or ST and narrow your choices (lateral syndromes will always involve ST and thalamic fibers- horner syn. like features- as both of them travel close to each other laterally)
Look for cranial nerves involved
Know which artery supply what part.

asmi
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01/14/04 - 01:20 AM

Thx guest!

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