Neuroscience II: Lesions

Insula

taste disturbance
loss of hearing

Periaqueductal Gray

diplopia
lateral strabismus
ptosis
mydriasis

Middle Cerebellar Peduncle

ataxia

Flocculus

ataxia

Superior Cerebellar Peduncle

dysdiadochokinesia
ataxia

Decussation of the Superior Cerebellar Peduncle

dysdiadochokinesia
ataxia

Vermis

hypotonia
ataxia
dysmetria
intention tremors

Fasciculus Gracilis

ipsilateral loss of deep sensibility from T6 down

Fasciculus Cuneatus

ipsilateral loss of deep sensibility from T6 up

Corticospinal Fibers

contralateral spastic paralysis

Precentral Gyrus
(Motor Cortex)

contralateral spastic paralysis
contralateral loss/reduction voluntary movement
contralateral spastic paralysis (distal flexors)
clasped knife rigidity
Babinski sign

Occipitotemporal Gyrus

agnosia
prosopoagnosia

Occipital Lobe

anopsia

Locus Coeruleus

REM sleep compromised

Vestibular Area

vertigo
nystagmus

Cerebral Aqueduct

hydrocephalus

Septal Area

transient fits of rage
increased water consumption

Parahippocampal Gyrus

loss of vital (limbic) functions: feeding, reproduction, emotion, and memory
loss of olfaction

Postcentral Gyrus

contralateral sensory loss

Inferior Frontal Gyrus

Broca's aphasia
expressive aphasia

Vagal Trigone

dysphagia
dysphonia
loss of parasympathetics
loss of gag reflex

Hypoglossal Trigone

ipsilateral tongue paralysis

Epithalamus

fits of rage

Supraoptic Nucleus

diabetes insipidus
polydipsia
polyuria

Tonsil

dysmetria
intention tremors

Medial Geniculate Body

diminished hearing, more pronounced contralaterally

Dorsal Rootlet(s)

ipsilateral loss of pain and temperature
ipsilateral loss of deep sensibility
ipsilateral flaccid paralysis

Acoustic Tubercle

loss of hearing

Superior Medullary Velum

inability to look down and in
(trochlear nerve decussates here)

Inferior Parietal Lobule

Wernicke's aphasia
receptive aphasia

Ventral Root(lets)

flaccid paralysis
atrophy
hypotonia
hyporeflexia
fasciculations
fibrillations

Pyramid

contralateral spastic paralysis

Pyramidal Decussation

bilateral spastic paralysis

Olive, Inferior Olivary Nucleus

ataxia

Inferior Cerebellar Peduncle

ipsilateral ataxia

Posterior Limb of Internal Capsule

contralateral spastic paralysis (distal flexors)
clasped knife rigidity
Babinski sign

Basilar Pons

contralateral spastic paralysis (distal flexors)
clasped knife rigidity
Babinski sign

Crus Cerebri

contralateral spastic paralysis (distal flexors)
clasped knife rigidity
Babinski sign

Red Nucleus

contralateral spastic paralysis (distal flexors)
clasped knife rigidity
Babinski sign

Facial Colliculus

Abducent: diplopia, medial strabismus
Facial: Bell's Palsy

Inferior Colliculus

contralateral hearing loss

Auditory Radiation

contralateral hearing loss

Optic Nerve

anopsia (loss of vision)

Superior Colliculus

lose light reflexes

Lateral Geniculate Body

contralateral homonymous hemianopsia

Optic Tract

contralateral homonymous hemianopsia

Optic Radiation

contralateral homonymous hemianopsia

Cuneus

contralateral homonymous lower quadrant anopsia with sparing of macula

Lingual Gyrus

contralateral homonymous upper quadrant anopsia with sparing of macula

Dentate Nucleus

decomposition of movement
(must think of subconscious movements)
truncal ataxia: dysrhythmia, dysdiadochokinesia

Lateral Cerebellar Hemispheres

decomposition of movement
think of subconscious movements
truncal ataxia: dysrhythmia, dysdiadochokinesia

Flocculonodular Lobe and Vermis

truncal ataxia and incoordination
unable to perform tandem gait
unsteady with eyes open/close during Romberg's test

Medial Olfactory Stria

cannot communicate with contralateral olfactory bulb

Anterior Commissure

cannot communicate with contralateral olfactory bulb

Lateral Olfactory Stria

olfaction loss

Fasciculus Cuneatus

ipsilateral loss of deep sensibility, T6 up

Fasciculus Gracilis

ipsilateral loss of deep sensibility, T6 down

Caudate Nucleus

Wilson's Disease

Lentiform Nucleus

dystonia musculorum deformans
Wilson's Disease

Putamen

dystonia musculorum deformans
Wilson's Disease

Globus Pallidus II, I

athetosis
dystonia musculorum deformans
Wilson's Disease

Subthalamic Nucleus

Wilson's Disease
ballism

Substantia Nigra

Wilson's Disease
Parkinson's Disease

Hippocampus

defects in explicit memory and spatial orientation

Dentate Gyrus

defects in explicit memory and spatial orientation

Mammillary Bodies

defects in spatial orientation
loss of memory and emotions
Korsakoff's psychosis

Cingulate Gyrus

defects in explicit memory and spatial orientation

Amygdala

diminished capacity for fear conditioning
possible amnesia

Medial Temporal Lobe

loss of explicit memory

Bilateral Temporal Lobes
(Amygdale + Hippocampus)

Kluver Bucy Syndrome
visual agnosia
hyperorality
hypersexuality
docility
apathy
bulimia
memory deficit

I - Olfactory

anosmia

II - Optic

anopsia

III - Oculomotor

diplopia
lateral strabismus
ptosis
mydriasis
cycloplegia

IV - Trochlear

diplopia
difficulty looking down and in

V - Trigeminal

trigeminal neuralgia
facial numbness
inability/difficulty to bite down

VI - Abducent

diplopia
medial strabismus

VII - Facial

Bell's Palsy
loss of taste from anterior 2/3rd of tongue
ipsilateral ptosis

VIII - Vestibulocochlear

vertigo
nystagmus
disequilibrium
hearing loss
tinnitus
Meniere's Disease

IX - Glossopharyngeal

hypotension/hypertension
pain or loss of sensation in nasopharyngeal area
reduced/absent gag reflex
loss of taste on posterior tongue

X - Vagus

dysphonia
dysphagia
loss of gag reflex
uvula deviation to strong side

XI - Accessory

dysphonia
dysphagia
unable to rotate head
unable to elevate shoulders

XII - Hypoglossal

ipsilateral tongue paralysis
atrophy

Precentral gyrus (upper)+ paracentral lobule (lower)

contralateral spastic paralysis

Premotor and Supplementary Motor Cortex

loss of motor preparation and programming

Prefrontal cortex

loss of motor integration and planning
loss of judgement
loss of language production on dominant hemisphere

Transverse Temporal Gyri of Hescl

loss of primary auditory cortex

Gustatory Cortex

loss of taste from tongue and epiglottis

Postcentral Gyrus + Paracentral Lobule

contralateral loss of sensation

Superior and Inferior Parietal Lobules

asterognosis
personal neglect syndrome
spatial neglect syndrome
Wernicke's aphasia
receptive aphasia

Anterior Tubercle

loss of memory and emotions
Korsakoff's syndrome

Pulvinar

impaired visual reflex
impaired eye movement

Habenula

loss of olfaction reflexes

Posterior Commissure

loss of visual reflexes

Pineal Gland

precocious puberty