1. BRAINSTEM
DR ANIL

2. GROSS ANATOMY OF THE
BRAINSTEM

9. THE MEDULLA: GROSS ANATOMY

16. INTERNAL STRUCTURE OF THE
MEDULLA

21. THE PONS GROSS ANATOMY

22. PONS - L. – a bridge

26. INTERNAL STRUCTURE OF THE
PONS

29. THE MIDBRAIN GROSS ANATOMY

34. INTERNAL STRUCTURE OF THE
MIDBRAIN

37. BLOOD SUPPLY OF BRAINSTEM

39. BLOOD SUPPLY
•
MEDULLA
1. 2 VERTEBRAL A
2. ANT &POST SPINAL A
3. ANT &POST INF CEREBELLAR A
4. BASILAR A

40. PONS
•
PONTINE BRANCHES OF BASILAR A
•
ANT INF CEREBELLAR A

41. MIDBRAIN
•
BASILAR A-DIRECT BRS
•
POST CEREBRAL A
•
SUP CEREBELLAR A
•
BRS OF POST COMM &ANT CHOROIDAL A

42. Syndromes

44. Wallenberg Syndrome
•
aka lat medullary syndrome
•
occ. of PICA
•
Posterolat part of medulla is
damaged
•
Features:
a) Inv of spinal nuc & tract of V
nerve
- ipsilateral loss of pain & temp from face
& forehead
b) Inv of spinal lemniscus (lat
spinothalamic tract) –
-contralateral loss of pain & temp
from body below face

45. c) Inv of nuc. Ambiguus –
- paralysis of muscles of soft
palate, pharynx & larynx-
- dysarthria & dysphagia
d) Inv of Vestibular nuclei - -
giddiness
This combination of sensory loss –
“Crossed Hemianaesthesia”

46. Medial Medullary Syndrome
Dejerine’s ant bulbar syndrom.
b/c vertebral a 
Click to edit the
XII nerve – i/l paralysis & outline text format
atrophy of 1/2 tongue ;
deviated to affected side 
Second Outline
Pyramid c/l hemiplegia/ Level
paralysis arm & leg.
medial lemniscus (post column
− Third Outline
fibres) - contralateral loss of Level
position & vibra. 
Fourth
This combination of motor loss
– Crossed motor paralysis Outline
Level

47. Millard-Gublar synd
•
Lesion in lower part of Pons
•
Incl pyramidal tract
•
Also inv 6 & 7 nerve fibers
•
Abd n. i/l med squint
•
Facial n i/l facial palsy
•
Corticospinal tract c/l hemiplegia

49. Pontine H’age
•
Pontine arteries rupture
•
Hyperpyrexia – thermoregulatory mech.
disrupted
•
Pinpoint pupils – contraction of sphincter
pupillae muscle
•
Coma – reticular formation lesion
•
Contralateral UMN paralysis – pyramidal
fibres involved

51. Weber's Syndrome
•
Ipsilateral oculomotor 
Click to edit the
palsy. outline text format
•
Contralateral
hemiplegia

Second Outline
Level
− Third Outline
Level

Fourth
Outline
Level

52. Benedikt's syndrome
•
Fibres of III nerve. 
Click to edit the
outline text format
•
Descending motor
fibres in cerebral 
Second Outline
peduncle. Level
•
Red nucleus and nearby
− Third Outline
cerebellothalamic Level
fibres. 
Fourth
Outline
Level