Dorsolateral midbrain syndrome

What is the dorsolateral midbrain syndrome? 

The dorsolateral midbrain syndrome is caused by infarction of the circumferential arteries and results in:

  • Ipsilateral Horner’s syndrome (damage to sympathetic tract).
  • Ipsilateral severe tremor that may be present at rest and grossly worsened by attempted movement (damage to superior cerebellar peduncle prior to crossing to the opposite red nucleus). Tremor and ataxia can be present bilaterally, if both the superior cerebellar peduncle and red nucleus are affected.
  • Contralateral loss of all sensory modalities (damage to spinothalamic tract and medial lemniscus that now ascend together).
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