Brainstem infarction

pons is divided into mid pons and inferior pons; lateral side and medial side. This division is based on blood supply.

infarction of medial pons causes ataxic hemiparesis (contralateral hemiparesis of limbs and ipsilateral paresis of facial muscles and ataxia due to involvement of middle cerebellar peduncle). There may also be a loss of sensation of touch and position sense.

Infarction of lateral part of mid pons causes involvement of sensory and motor division of cranial nerve five (weakness of masticatory muscles, diminished jaw jerk)

Infarction of the lateral part of the inferior pons causes involvement of cranial nerves seven and eight.

Infarction of the medial part of medulla oblongata causes alternate hypoglossal hemiplegia (tongue deviates toward the side of the lesion and limb paresis occurs on the opposite side). there is also a loss of vibration and proprioception on the contralateral side.

Infarction of the lateral part of medulla oblongata causes Horner syndrome, vestibulocerbellar involvement (ipsilateral ataxia, vertigo, nystagmus ), ipsilateral bulbar muscle weakness, loss of pain and temperature on the ipsilateral face and contralateral body
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