神经(shénjīng)解剖学脑干损伤lesionsofthebrainstem第一页，共二十三页。第二页，共二十三页。第三页，共二十三页。第四页，共二十三页。第五页，共二十三页。第六页，共二十三页。第七页，共二十三页。第八页，共二十三页。第九页，共二十三页。第十页，共二十三页。第十一页，共二十三页。第十二页，共二十三页。第十三页，共二十三页。第十四页，共二十三页。第十五页，共二十三页。第十六页，共二十三页。Medial(basal)medullarysyndromeusuallyinvolvesthepyramid,partorallofthemediallemniscus,andnerveXII.Ifitisunilateral,itisalsoknownasalternatinghypoglossalhemiplegia(Fig7-12);thetermreferstothefindingthatthecranialnerveweaknessisonthesamesideasthelesion,butthebodyparalysisisontheoppositeside.Largerlesionscanresultinbilateraldefects.Theareainvolvedissuppliedbytheanteriorspinalarteryorbymedialbranchesofthevertebralartery.第十七页，共二十三页。Lateralmedullary,orWallenberg's,syndromeinvolvessome(orall)ofthefollowingstructuresintheopenmedullaonthedorsolateralside(seeFig7-12):inferiorcerebellarpeduncle,vestibularnuclei,fibersornucleiofnerveIXorX,spinalnucleusandtractofV,spinothalamictract,andsympatheticpathways.(InvolvementofthesympatheticpathwaysmayleadtoHoner'ssyndrome.)Theaffectedareaissuppliedbybranchesofthevertebralarteryor,mostcommonly,theposteriorinferiorcerebellarartery.AnexampleisprovidedinClinicalIllustration7-1.第十八页，共二十三页。Basalpontinesyndromescaninvolveboththecorticospinaltractandacranialnerve(VI,VII,orV)intheaffectedregion,dependingontheextentandlevelofthelesion(Fig7-13).Thesyndromeiscalledalternatingabducens(VI),facial(V),ortrigeminalhemiplegia(V).Ifthelesionislarge,itmayincludethemediallemniscus.Thevascularsupplycomesfromtheperforators,orpontinebranches,oftheanteriorinferiorcerebellarartery.第十九页，共二十三页。DorsalponssyndromeaffectsnerveVIorVIIortheirrespectivenuclei,withorwithoutinvolvementofthemediallemniscus,spinothalamictract,orlaterallemniscus.The"lateralgazecenter"isofteninvolved(seeFig8-7).Atamorerostrallevel,nerveVanditsnucleimaynolongerbefunctioning.Theaffe...
