Gold Edition: Exhaustive Reference
| Syndrome | Location | Affected Structures | Clinical Presentation |
|---|---|---|---|
| Brown-Séquard | Hemisection | Dorsal Cols, CST, Spinothalamic | Ipsi: Loss of Vib/Prop (at & below), UMN signs (below), LMN signs (at level). Contra: Loss of Pain/Temp (1-2 segments below). |
| Syringomyelia | Central Canal (C8-T1) | Ant. White Commissure | Bilateral "Cape-like" loss of Pain/Temp (Upper extremities). Fine touch preserved. Assoc w/ Chiari I. |
| Subacute Combined Degeneration | Dorsal Col + Lat CST | Myelin (B12 deficiency) | Ataxia, Paresthesia, UMN signs (Spasticity, +Babinski). Tip: B12 def also has megaloblastic anemia. Vit E def looks similar but no anemia. |
| Tabes Dorsalis | Dorsal Roots/Cols | Treponema pallidum (Syphilis) | Sensory Ataxia, +Romberg, Absent DTRs, "Lightning pains", Argyll Robertson pupils. |
| ALS | Ant Horn + Lat CST | Motor Neurons (UMN+LMN) | Combined UMN (hyperreflexia) + LMN (fasciculations/atrophy). NO sensory loss. Assoc w/ SOD1 mutation. |
| Ant. Spinal Artery (ASA) | Ant 2/3 Cord | CST, Spinothalamic, Ant Horn | Complete paralysis below lesion. Loss of pain/temp below. Sparing of Dorsal Columns (Vib/Prop). |
| Cauda Equina | Lumbar Roots | Nerve Roots (L2+) | Saddle anesthesia, Bowel/Bladder dysfunction, Absent anal wink. Surgical Emergency. |
| Syndrome | Vessel | Key Structures | Deficits |
|---|---|---|---|
| Medial Medullary | ASA | CST, Medial Lemniscus, CN XII | Contra hemiparesis, Contra prop/vib loss. Ipsi Tongue Deviation ("Lick your wounds"). |
| Lat Medullary (Wallenberg) | PICA | Spinothalamic, Symp, Nucleus Ambiguus | Contra pain/temp (body). Ipsi pain/temp (face). Dysphagia, Hoarseness, ↓ Gag reflex. Horner syndrome. Vertigo. |
| Lat Pontine | AICA | Spinothalamic, Symp, CN VII, VIII | Contra pain/temp (body). Ipsi pain/temp (face). Facial Paralysis + Hearing Loss/Tinnitus. NO hoarseness. |
| Medial Pontine | Basilar | CST, CN VI | Contra hemiparesis. Ipsi CN VI palsy (Lat Rectus - cannot look out). |
| Locked-In | Basilar | Bilateral Ventral Pons | Quadriplegia. Horizontal gaze palsy. Vertical gaze/blinking spared. |
| Weber (Midbrain) | PCA | CST, CN III | Contra hemiparesis. Ipsi CN III palsy (Down & Out, Blown Pupil). |
| CN | Name | Exit | Function/Deficit |
|---|---|---|---|
| I | Olfactory | Cribriform | Smell. Anosmia (Kallmann syndrome). |
| II | Optic | Optic Canal | Vision. Afferent of Pupillary Reflex. |
| III | Oculomotor | SOF | Most eye muscles, pupil constriction, lid elevation. Lesion: "Down & Out", Ptosis, Mydriasis. |
| IV | Trochlear | SOF | Sup. Oblique. Lesion: Eye drifts UP (Head tilt away from lesion). |
| V | Trigeminal | SOF/Rot/Ovale | Sensation (Face), Mastication. Lesion: Jaw deviates TOWARD side of lesion. |
| VI | Abducens | SOF | Lat. Rectus. Lesion: Eye turns IN. |
| VII | Facial | Int. Auditory | Face motor, Taste (ant 2/3), Tear/Saliva. Lesion: Bell's Palsy (whole half of face). |
| VIII | Vestibulocochlear | Int. Auditory | Hearing/Balance. Lesion: Vertigo, Deafness. |
| IX | Glossopharyngeal | Jugular | Taste (post 1/3), Swallowing, Carotid body. Lesion: Loss of Gag. |
| X | Vagus | Jugular | Viscera, Swallowing, Voice. Lesion: Uvula deviates AWAY from lesion. |
| XI | Accessory | Jugular | SCM/Trapezius. Lesion: Shoulder droop, cant turn head contra. |
| XII | Hypoglossal | Hypoglossal | Tongue motor. Lesion: Tongue deviates TOWARD lesion. |
| Thalamic Nucleus | Input | Destination/Function |
|---|---|---|
| VPL | Spinothalamic/DCML | Somatosensory Cortex (Body sensation) |
| VPM | Trigeminal/Gustatory | Somatosensory Cortex (Face sensation/Taste) |
| LGN | CN II (Optic) | Calcarine Sulcus (Vision). "Lateral = Light" |
| MGN | Superior Olive | Temporal Lobe (Hearing). "Medial = Music" |
| VL | Basal Ganglia/Cerebellum | Motor Cortex (Movement planning) |
| Location | Defect | Etiology |
|---|---|---|
| Optic Nerve | Monocular Blindness | MS (Optic Neuritis). |
| Optic Chiasm | Bitemporal Hemianopia | Pituitary Adenoma / Craniopharyngioma. |
| Optic Tract | Contra Homonymous Hemianopia | PCA stroke (rarely). |
| Meyer's Loop (Temporal) | Contra Upper Quadrantanopia ("Pie in Sky") | MCA stroke (Inferior division). |
| Dorsal Radiation (Parietal) | Contra Lower Quadrantanopia ("Pie in Floor") | MCA stroke (Superior division). |
| Occipital Cortex | Hemianopia with Macular Sparing | PCA stroke (Macula has MCA collateral). |
| Disease | Protein Pathology | Key Genes/Findings |
|---|---|---|
| Alzheimer | Intra: Tau (Tangles) Extra: Amyloid (Plaques) | APP (Chr 21), Presenilin 1 (Chr 14), ApoE4 (Late onset). |
| Parkinson | Alpha-Synuclein | Lewy Bodies. Depigmentation of Substantia Nigra. TRAP symptoms. |
| Lewy Body Dementia | Alpha-Synuclein | Dementia + Visual Hallucinations + Parkinsonism. |
| Frontotemporal (Pick) | Tau (Pick bodies) or TDP-43 | Personality change, Aphasia. "Knife-edge" atrophy. |
| Huntington | CAG Repeat (Chr 4) | Caudate atrophy (Boxcar ventricles). Anticipation. Decreased GABA/ACh. |
| Creutzfeldt-Jakob | Prions (PrP-sc) | Spongiform cortex. Rapidly progressive. Startle myoclonus. |
| Tumor | Demographic | Histology/Features |
|---|---|---|
| Glioblastoma | Adults | "Butterfly" lesion. Pseudopalisading necrosis. GFAP+. Worst prognosis. |
| Meningioma | Adults | Parasagittal. Psammoma bodies (whorled). Spindle cells. |
| Schwannoma | Adults | Cerebellopontine angle (CN VIII). S-100+. Bilateral = NF2. |
| Oligodendroglioma | Adults | Frontal lobe calcification. "Fried Egg" cells. Chicken-wire capillaries. |
| Pilocytic Astrocytoma | Children | Cerebellum. Cystic + solid nodule. Rosenthal fibers (corkscrew). Benign. |
| Medulloblastoma | Children | Cerebellum (Vermis). Homer-Wright Rosettes. Malignant (Drop metastasis). |
| Ependymoma | Children | 4th Ventricle. Perivascular rosettes. Hydrocephalus. |
| Class | Drugs | Metabolism |
|---|---|---|
| Esters | Procaine, Cocaine, Tetracaine | Plasma esterases (High allergy risk). 1 'i' in name. |
| Amides | Lidocaine, Mepivacaine, Bupivacaine | Liver. 2 'i's in name. |
| Blockade Order | Small Myelinated > Small Unmyelinated > Large Myelinated > Large Unmyelinated. Pain > Temp > Touch > Pressure. | |