Brain Stem Lesions And Crossed Brain Stem Syndromes

Objective: To investigate the relationship of the crossed brain stemsyndromes in topographical localization and pathological nature, and re-cognatethe crossed brain stem syndromes in brain stem lesions.Methods: We studied consecutively78patients with stem lesions whowere admitted to the First Affiliated Hospital of Guangxi MedicalUniversity between September2010and January2012and whose lesion wasshown by MRI. We collected and summarize the clinical manifestations, and thetopographical localization and the pathological nature. Subsequently weanalyzed the distribution of crossed brain stem syndromes in the brainstem lesions, compared with the classical brainstem syndrome.Results: Of the78patients, lesion location was medullary in11patients,pontine in46, mesencephalic in4, pontonmedullary in5, pontomesencephalic in11, one patient had a lesion encompassing the mesencephalic, pontine andmedullary. There is12cases with the crossed brain stem syndromes, accountingfor15.38%(12/78). In which, the clinical features of4patients were consistentall symptoms described with classical crossed brain syndromes,7patients didnot fulfill or had additional symptom compared with classical crossed brain syndromes,1patients with the crossed brain syndrome that have not beendescribed yet.Of the12patients with the crossed brain syndrome，lesion location wasmedullary in7patients, mesencephalic in4, pontonmedullary in2,pontomesencephalic in11, one patient had a lesion encompassing themesencephalic, pontine and medullary. The pathological nature of12cases werecomplex and diverse, including5cases with brain stem infarction,3caseswith primary brain stem hemorrhage,1case with inflammatory diseases,1casewith hemorrhage of cavernous hemangioma,2cases were not clear.Conclusion:1.In the brain stem lesions, the crossed brain stemsyndromes appearing in the medullary is more common while appearing in themesencephalic or pontine is less.2.The character of the brain stem lesions iscomplex and diverse, and so do the crossed brain stem syndromes.3. Somekinds of crossed brain syndrome have not been described yet.