Midbrai

Pons

Medial
(posterior cerebral
artery)

Weber

Tegmentum

Benedikts

Ipsilateral

Corticospinal tract
Red nucleus

Contralateral
Contralateral

Occulomotor
nerve
Medial lemniscus

Ipsilateral
Contralateral

Tectum

Parinaud

Superior colliculus

Medial

Raymonds

Corticospinal tract
Abducens nerve
Medial lemniscus

Contralateral
Ipsilateral
Contralateral

Lateral

MillardGubler

Facial nerve

Contralateral

Abducens nerve
Corticospinal tract
Medial lemniscus
Medial
longitudinal
fasciculus
Vestibulocochlear
nerve

Ipsilateral
Contralateral
Contralateral
Contralateral

Contralateral
Contralateral

Contralateral

Dorsal

Fouvilles

Acoustic
neuroma
(tumor
arising from
Schwann
cells in
sheath of CN
VIII)
Medulla

Occulomotor
nerve

Medial
(medullary branch
of vertebral artery)

Medial
medullary

Facial nerve
Trigeminal spinal
tract nucleus
Medial lemniscus
Hypoglossal nerve

Lateral
(posterior inferior
cerebellar artery)

Wallenberg

Pyramid
Vestibular nuclei
Inferior cerebellar
peduncle
Nucleus ambiguus
Trigeminal spinal
tract nucleus
Descending
sympathetic chain

Medulla and
cerebellar tonsils

Arnold-Chari
(herniation)

Roof of fourth
ventricle

Ipsilateral

Contralateral
Ipsilateral

Contralateral
Ipsilateral

Contralateral
Ipsilateral

CN
o
o
o

III palsy:
Ptosis
Dilated pupil
External
strabismus
Spastic hemiplegia
Ataxia and choreic
movements
CN III palsy
(-) Proprioception
(-) Discriminative
touch
Paralysis of upward
gaze
Spastic hemiplegia
Internal strabismus
(-) Proprioception
(-) Discriminative
touch
Paralysis of lower
face
Internal strabismus
Spastic hemiplegia
(-) Proprioception
Nystagmus
Sensorineural
deafness
(-) Proprioception
Vertigo
Nausea
Vomiting
Paralysis of face
(-) Pain
(-) Temperature
(-) Proprioception
Tongue paralysis
(deviates to side of
lesion)
Spastic hemiparesis
Vomiting
Vertigo
Nystagmus
Limb ataxia
Dysarthria
Dysphagia
Dysphonia
(-) Pain
(-) Temperature
Horners syndrome:
o Ptosis
o Enopthalmos
o Miosis
o Anhydrosis
Internal
hydrocephalus

Spinal
cord

BrownSequard

Dorsal column
Spinothalamic
tract
Corticospinal tract

Poliomyelitis
(polio virus)
Cervical levels

Anteromedian
sulcus

Central canal

Lower motor
neuron
Descending
hypothalamics
Lower motor
neuron

Ipsilateral
(at/below lesion)
Contralateral
(at lesion)
Bilateral
(below lesion)
Ipsilateral
(below lesion)
Bilateral

(-)
(-)
(-)
(-)

Ipsilateral

Horners syndrome

Bilateral

Flaccid paralysis
Hyporeflexia
Hypotonicity
Muscle atrophy
Progressive spinal
muscular atrophy
Spastic paralysis of
LL
Flaccid paralysis of
UL
Hyperreflexia
Hypertonicity
Spastic paresis

Amyotrophic
lateral
sclerosis

Ventral horn
Corticospinal tract

Bilateral

Anterior
spinal artery
occlusion

Corticospinal tract

Bilateral
(below lesion)
Bilateral
(below lesion)
Bilateral

Tabes
dorsalis
(neurosyphili
s)
Syringomyeli
a

Subacute
combined
degeneration
(vitamin B12
deficiency)
Multiple
sclerosis

Spinothalamic
tract
Dorsal column

Central canal
Spinothalamic
tract
Lower motor
neuron
Descending
hypothalamic
fibers
Dorsal column

Bilateral
(at lesion)
Bilateral

Corticospinal tract
Optic nerve

Bilateral

Corticospinal tract
Dorsal column
Spinocerebellar
tract
Medial
longitudinal
fasciculus

Bilateral
Bialteral

Proprioception
Vibratory sense
Pain
Temperature

Paresis
Flaccid paralysis

(-) Pain
(-) Temperature
(-) Proprioception
(-) Vibratory sense
(-) Tactile
discrimination
Progressive
cavitation
(-) Pain
(-) Temperature
Flaccid paralysis
Horners syndrome

Bilateral

(-) Proprioception
(-) Vibratory sense
(-) Tactile
discrimination
Spastic paresis
Monocular
blindness
Spastic paresis
Paresthesia
Ataxia
Diplopia

Thalamus

Thiamine
deficiency

Thalamic
pain
syndrome

Korsakoff
syndrome

Pineal
gland

Dorsomedial
nucleus of
thalamus
Mammillary
bodies
Hippocampus
Vermis of
cerebellum
Ventral nuclear
group
Ventral
posterolateral
sensory nuclei
Mammillary
bodies

Pineal
tumors

Upper midbrain,
pretectal area
Hippocam
pus
Amygdala
and
hippocamp
us

Alzheimers
Kluver-Bucy

Contralateral
Contralateral

Burning, aching
pain in limbs or
body
(-) Vibratory sense
Gait ataxia
Pain sensitivity
Anterograde
amnesia
Retrograde
amnesia
Confabulations
Obstruction of CSF
flow
Increased
intracranial
pressure
Parinaud syndrome
Anterograde
amnesia
Psychic blindness
Decreased
aggressive
behavior
Hypermetamorphos
is
Hypersexuality
Anterograde
amnesia
Increased oral
exploratory
behavior

Cerebellu
m

Cerebrum

Premotor areas

Ideomotor
apraxia
Ideotional
apraxia
Visual
agnosia
Tactile
agnosia
Auditory
agnosia

Dominant
supramarginal
gyrus
Dominant
parietal lobe or
corpus callosum
Visual unimodal
association areas
Supramarginal
gyrus
Posterior part of
superior
temporal gyrus

Dysarthria
Aphonia
Brocas
aphasia

Brocas area

Wernickes
aphasia
Conduction
aphasia

Wernickes area

Global
aphasia
Gertsmann

Wernickes and
Brocas areas

Balint

Temporoparietal
heteromodal
association areas

Arcuate and
superior
longitudinal
fasciculi

Hypotonia
Postural changes
Ataxic gait
Tremors
Decomposition of
movement
Dysdiadochokinesia
Disturbance of
reflexes
Nystagmus
Dysarthria
Patient knows what to do but is unable
to perform
Failure to carry out sequences of acts
Correct individual movements
Failure to recognize object by sight
Can be identified by other senses
(touch)
Failure to recognize object by touch
Failure to recognize what patient
hears
Disturbance is speech execution
without language disorder
Inability to produce sounds
Slow, effortful spoken language
Poorly produced sounds
Ungrammatical
Telegraphic speech
Rapid spoken language
Correct grammar
Fluent aphasia
Poor repetition of spoken language

Acalcula
Agraphia
Finger agnosia
Right/left disorientation

Autonomic
nervous
system

Spinal shock
(diaschisis)
Hirschsprungs
(megacolon)
Horners

Transection/severe injury of spinal

cord
Congenital lack of sympathetic
ganglia
Sympathetic pathways in carotid
plexus, cervical sympathetic chain,
upper thoracic cord, brainstem

Causalgia

Median nerve or sciatic nerve

Reynauds

Peripheral vascular innervation (toes,

fingers, edges of ears, tip of nose)

Extreme dilation of colon

Chronic constipation
Ipsilateral
Ptosis
Flushing of face
Miosis
Enopthalmos
Severe burning pain
Glossy skin
Swelling
Redness
Sweating
Trophic nail changes
Local asphyxia
Blue-gray cyanosis
Symmetric dry gangrene

UL
(above
T5)

Lateral
spinothalami
c

LL
(below
T6)

Pain
Ventral
spinothalami
c

Crude touch

Dorsal
column
medial
lemniscal

Discriminati
ve touch

Groups
of LL
muscles

Ventral
spinocerebell
ar

Individu
al LL
muscles

Dorsal
spinocerebell
ar

UL

Cuneocerebellar

Face

Temperatur
e

Ventral
trigeminotha
lamic

RECEPTOR
Krausse end
bulb (cold)
Ruffinis
corpuscle (hot)
Free nerve
endings
Meissners
corpuscle

N1

N2
Posterior
horn cell
(substanti
a
gelatinos
a)

N3
VPLN
(decussat
e)

N4
BA
3,1,2

Posterior
horn cell
(substanti
a
gelatinos
a)
Nucleus
gracilis

VPLN
(decussat
e)

BA
3,1,2

VPLN
(decussat
e)

BA
3,1,2

Nucleus
dorsalis
(decussat
e)
Nucleus
dorsalis

Superior
cerebellar
peduncle

N/A

Inferior
cerebellar
peduncle

N/A

DRG

Nucleus
cuneatus

Inferior
cerebellar
peduncle

N/A

Trigeminal
ganglion
(Gasserian)

Nucleus
of
trigemina
l spinal
tract
(decussat
e)
Main
sensory
nucleus
of
trigemina
l nerve
(decussat
e)

VPMN

BA
3,1,2

VPMN

BA
3,1,2

Main
sensory
nucleus
of
trigemina
l nerve
(decussat
e)

VPMN

BA
3,1,2

DRG

DRG

Merkels disc

Conscious
propriocepti
on
Unconsciou
s
propriocepti
on
Unconsciou
s
propriocepti
on
Unconsciou
s
propriocepti
on
Pain
Temperatur
e

Touch
Pressure

Hair follicle
Pacinian
corpuscle

DRG

Meissners
corpuscle
Muscle/tendon
spindles
Muscle spindle

Nucleus
cuneatus

DRG

Golgi tendon
Muscle spindle

DRG

Golgi tendon
Muscle/tendon
spindles
Cutaneous/joint
receptors
Free nerve
endings
Krausse end
bulb (cold)
Ruffinis
corpuscle (hot)
Merkels disc

Trigeminal
ganglion

Meissners
corpuscle
Pacinian
corpuscle
Propriocepti
on

Hair follicle
Teeth
Muscles of
mastication
Temporomandib
ular joint

Mesenceph
alic nucleus

Visual
pathway
Direct
and
consensu
al light
reflexes
Corneal
reflex

Accomida
tion
reflex

Visualbody
reflex
Scanning
movement
of eyes
and head
Pupillaryskin
reflex
Pupil
dilates with
pain on
skin
Auditory
pathway

Vestibular
pathway

1
Rods and cones

2
3
4
5
Bipolar neurons
Ganglion cells of
Lateral
BA 17
of retina
retina
geniculate body
1
2
3
4
5
6
7
8
Optic
Optic
Optic
Pretectal
EdingerCiliary
Short
Constricto
nerve
chiasm
tract
nucleus
Westphal
ganglion ciliary
r pupillae
nucleus of
nerves
CN III
1
2
3
4
5
Cornea
CN V1
Nucleus of CN V
Internuncial
Orbicularis oculi
Conjunctiva
neurons connect
with motor
nucleus of CN
VII
1
2
3
4
5
6
7
Optic nerve Optic
Optic tract
Lateral
Optic
Visual
Internal
chiasm
geniculate
radiation
cortex
capsule
body
8
9
10
11
Occulomot
Medial
or nuclei in
rectus
midbrain
EdingerCiliary
Short
Constrictor
Westphal
ganglion
ciliary
pupillae
nucleus of
nerves
CN III
1
2
3
4
5
6
7
Optic nerve Optic
Optic tract
Superior
Tectospina Anterior
Cranial
chiasm
colliculi
l and
gray
motor
tectobulba column
nuclei
r tracts
1
White rami
communican
tes

1
Organ
of
corti

2
Spiral
gangli
on

2
Sympathetic
trunk

3
Cochle
ar
nucleu
s

1
Utricle/saccule
Semicircular canals

3
Superior
cervical
sympathetic
ganglion

4
Trapezo
id
body/
olivary
nucleus

5
Posteri
or
nucleu
s of
trapezo
id
body/
superio
r
olivary
nucleu
s

2
Vestibular ganglion

4
Internal
carotid plexus

6
Lateral
lemniscu
s
(decussa
te)

5
Long ciliary
nerves

7
Nucle
us of
inferio
r
collicu
ls

3
Vestibular nuclear
complex

8
Medial
genicul
ate
body

6
Dilator
pupillae

9
Auditor
y
radiati
on

10
Audito
ry
cortex

4
Cerebellum
Vestibulospinal tract
Extraoccular muscles

Postcentral gyrus

Olfactory
pathway

Increased
salivation

Increased
gastric
secretion
Vomiting

Grimacing

1
Olfacto
ry cells

2
Mitral
cells in
olfacto
ry bulb

3
Lateral
olfacto
ry
striae
Medial
olfacto
ry
striae

Dorsal
tegmental
nucleus

4
Primary
olfactor
y cortex

5
Second
ary
olfactor
y cortex
Habenul
ar
trigone
nucleus

Anterior
Interpedunc
perforat
ular nucleus
ed
substan
ce
Otic ganglion
CN IX

Dorsal
tegmen
tal
nucleus

Motor
nuclei

Inferior
salivatory
nucleus
Superior
Submandibular
CN VI
salivatory
ganglion
nucleus
Dorsal tegmental
Dorsal motor
Meissners plexus in
nucleus
nucleus of CN X
stomach submucosa
Dorsal tegmental
nucleus

Dorsal motor
nucleus of CN X
Anterior horn cells
of T7-L1
Nucleus ambiguous

Dorsal tegmental nucleus

CN VII

Myenteric plexus

Parotid gland
Submandibular
and sublingual
glands
Gastric glands
Smooth muscles of
stomach

Anterolateral
abdominal muscles
Ariepiglottic
muscles
Facial muscles