Brain stem vascular lesions

Occlusion of the anterior spinal artery causes medial medullary syndrome, presenting
with inferior alternating hemiplegia.
Ipsilateral paralysis of tongue.
Contralateral hemiplegia.
Contralateral sensory deficits.
Occlusion of the posterior inferior cerebelllar artery causes lateral medullary
syndrome featured
Contralateral hemianaesthesia of the body below the head.
Ipsilateral hemianaesthesia of the face.
Cerebellar dysfunction.
Speech and swallowing disorders.
Horners syndrome.
Occlusion of the paramedian branches of the basilar arteries causes middle
alternating hemiplegia.
Contralateral hemiplegia.
Medial deviation of the eyeball.

Obstruction of the short circumferential arteries from the basilar artery cause
Ipsilateral cerebellar dysfunction
Autonomic disturbances
Contralateral hemianaesthesia

Occlusion of the mesencephalic branch of the posterior cerebral artery causes
Weber's syndrome
Contralateral hemiplegia
Ipsilateral lateral deviation of the eyeball
Cerebral Cortical ascular !esions
Occlusion of the anterior choroidal artery causes a triad of"
Contralateral hemiplegia
Hemianopia
Hemi hyperacusis

Occlusion of anterior cerebral arteries may cause
Contralateral hemiplegia
Contralateral hemianaesthesia # both mainly affect the lower limb$
Agnosia
%ersonality changes

Occlusion of the calcarine artery causes homonymous hemianopia with macular
sparing (Tunnel vison)

Occlusion of the middle cerebral artery near the origin of its cortical branches
causes
Contralateral hemiplegia , most mar&ed in the upper e'tremity and face.
Contralateral loss of position sense and discriminatory touch.
(lobal aphasia if its on the dominant side.
%artial deafness.
Components of the BBB
)ight *unctions between the capillary endothelial cells
Continuous homogenous basement membrane
+umerous astrocytic processes
%arts devoid of ,lood ,rain ,arrier - circumventircular organs #CO$.
)he pineal body
)he subcommissural organ
)he subfornical organ
)he organum vasculosum of the lamina terminalis #supra-optic crest$
)he median eminence
)he neurohypophysis
)he area postrema
Formation of Circle of Willis
)his is the communication between vessels about the interpeduncular fossa.
It encircles the optic chiasma, tuber cinereum and interpeduncular region.
Formed by these arteries
%osterior cerebral
Internal carotid
%osterior communicating
Middle cerebral
Anterior cerebral
Anterior communicating

The !nternal Carotid "rtery
Summary of the branches
Hypophyseal branches to the hypophysis cerebri
Ophthalmic artery
%osterior communicating artery
Anterior choroidal artery
Middle cerebral artery
Anterior cerebral artery