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Anatomy of the head and neck
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
The brainstem contains many ascending and descending nerve tracts, some of which terminate in brainstem nuclei located in this region. Functionally, important centres controlling respiration, cardiovascular function and levels of consciousness, forming the reticular system, are located within the brainstem. The cranial nerves III-XII are attached to the brainstem, with their fibres either originating from, or terminating in, the appropriate cranial nerve nuclei.
Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
A characteristic feature of SCA1 pathology is the atrophy and loss of Purkinje's cells from the cerebellar cortex. As SCA1 progresses, pathology is noted in other regions of the brain, including the deep cerebellar nuclei, especially the dentate nucleus, inferior olive, pons, and red nuclei. Cranial nerve nuclei III, X, and XII can also show signs of pathology. A pathologic hallmark of SCA1, as well as most of the other polyglutamine disorders, is the presence of the large inclusions containing the mutant polyglutamine protein. Besides containing mutant ATXN1, the inclusions are positive for ubiquitin and components of the proteasome and chaperone systems.
The nervous system and the eye
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
James A.R. Nicoll, William Stewart, Fiona Roberts
The brainstem is divided into the midbrain, pons and medulla. Each region contains cranial nerve nuclei and ascending and descending pathways. The principal structures of the midbrain include the colliculi, cerebral peduncles, third and fourth cranial nerve nuclei and the medial longitudinal fasciculus. Symptoms and signs of a lesion in the midbrain include contralateral spastic hemiplegia, diplopia and impairment of vertical eye movements and convergence. Syndromes due to disease in either the pons or the medulla reflect the involvement of sensory and motor long tracts, cranial nerve nuclei and vital centres involved in respiration and control of the heart; if there are bilateral paramedian lesions the patient may become ‘locked in’.
Disorders of vision in multiple sclerosis
Published in Clinical and Experimental Optometry, 2022
Roshan Dhanapalaratnam, Maria Markoulli, Arun V Krishnan
The supranuclear control of ocular movements is a complex but elegant network receiving input from the brainstem, cranial nerve nuclei, thalamus, basal ganglia and the cerebrum, as well as the vestibulocerebellar system.79 Such is the complexity of the network that several components are responsible for a single eye movement. Frontal eye field regions of the cortex are responsible for central primary gaze and a lesion in this area may result in an ipsilateral gaze deviation.80 Saccades are rapid intentional movements of the eyes to follow targets in the environment and can also be assessed when triggered by testing the vestibuloocular reflex (VOR), which keeps the eyes fixed on a target whilst the head is in motion. In contrast, pursuit is the ability to hold a steady gaze during motion.
Foix-Chavany-Marie syndrome due to unilateral anterior opercular infarction with leukoaraiosis
Published in Baylor University Medical Center Proceedings, 2021
Katherine Rivas, Jie Pan, Angela Chen, Bailey Gutiérrez, Parunyou Julayanont
The current mapping of the divisions of the operculum has demonstrated that stimulation causes motor and language deficits as well as somatosensory and oropharyngeal symptoms.5 The anterior operculum contains the voluntary motor fibers for the 5th, 7th, 9th, 10th, and 12th cranial nerves, which then travel to the cranial nerve nuclei via the corticobulbar tract.1,2 Injury to this area can cause FCMS bilateral voluntary paralysis of facial, masticatory, pharyngeal, laryngeal, and brachial muscles.6–8 Autonomic-voluntary dissociation in FCMS is explained by the presence of alternative pathways for facial emotional expression and automatic movements, hypothesized to be mediated through the inner forebrain and outer longitudinal bundle that connect the amygdala and hypothalamus to the brainstem.1,2
Duane Retraction Syndrome: Clinical Features and a Case Group-Specific Surgical Approach
Published in Seminars in Ophthalmology, 2019
Abuzer Gunduz, Ercan Ozsoy, Pamuk Betul Ulucan
Duane retraction syndrome (DRS) is a congenital ocular movement disorder characterized by moderate-to-severe limitation in abduction and/or adduction, as well as narrowing of the palpebral fissure, globe retraction, and vertical deviation of the affected eye on adduction.1 There is often a congenital anomaly of the sixth cranial nerve nuclei, with aberrant innervation supplied from the third cranial nerve.2 DRS is the most common form of congenital cranial dysinnervation disorders .3 It has an incidence of approximately 0.1% of the general population and accounts for 1–5% of all strabismus cases.4,5 DRS is primarily unilateral, although it presents bilaterally in 15% of all DRS patients.6 DRS type I is characterized by limited abduction, type II by limited adduction, and type III by limited abduction and adduction.7