Weber's syndrome

Weber's syndrome
Classification and external resources
Midbrain cross section showing lesion
ICD-10	G 46.3
ICD-9	344.89
DiseasesDB	31247
MeSH	D020526

Weber's syndrome (superior alternating hemiplegia) is a form of stroke characterized by the presence of an oculomotor nerve palsy and contralateral hemiparesis or hemiplegia.

1 Cause and presentation
2 History
3 References
4 External links

Cause and presentation

This lesion is usually unilateral and affects several structures in the midbrain including:

Structure damaged	Effect
substantia nigra	contralateral parkinsonism because its dopaminergic projections to the basal ganglia innervate the ipsilateral hemisphere motor field, leading to a movement disorder of the contralateral body.
corticospinal fibers	contralateral hemiparesis and typical upper motor neuron findings
corticobulbar tract	difficulty with contralateral lower facial muscles and hypoglossal nerve functions
oculomotor nerve fibers	ipsilateral oculomotor nerve palsy with a drooping eyelid and fixed wide pupil pointed down and out. This leads to diplopia

It is caused by midbrain infarction as a result of occlusion of the paramedian branches of the posterior cerebral artery or of basilar bifurcation perforating arteries.^[1]

History

It carries the name of Sir Herman David Weber, a German-born physician working in London, who described the condition in 1863.^[2]^[3] It is unrelated to Sturge-Weber syndrome or Klippel-Trenaunay-Weber syndrome.

References

^ -932511721 at GPnotebook
^ Weber HD (1863). "A contribution to the pathology of the crura cerebri". Medico-Chirurgical Transactions 46: 121–139.
^ synd/407 at Who Named It?

External links

CNS disease, Vascular disease: Cerebrovascular diseases (G45–G46 and I60–I69, 430–438)

Brain ischemia/
cerebral infarction
(ischemic stroke/TIA)

TACI, PACI	precerebral: Carotid artery stenosis cerebral: MCA · ACA · Amaurosis fugax Moyamoya disease

POCI	precerebral: Anterior spinal artery syndrome · Vertebrobasilar insufficiency (Subclavian steal syndrome) brainstem: medulla (Medial medullary syndrome, Lateral medullary syndrome) · pons (Medial pontine syndrome/Foville's, Lateral pontine syndrome/Millard-Gubler) · midbrain (Weber's, Benedikt, Claude's) cerebral: PCA · Lacunar stroke · Dejerine–Roussy syndrome cerebellar

General	cerebral: Cerebral venous sinus thrombosis · CADASIL · Binswanger's disease · Transient global amnesia

Intracranial hemorrhage
(hemorrhagic stroke)

Extra-axial	Epidural · Subdural · Subarachnoid

Cerebral/Intra-axial	Intraventricular

Brainstem	Duret haemorrhage

Aneurysm

Cerebral aneurysm (Intracranial berry aneurysm, Charcot-Bouchard aneurysm)

Other/general

Cerebral vasculitis

M: CNS

anat(n/s/m/p/4/e/b/d/c/a/f/l/g)/phys/devp

noco(m/d/e/h/v/s)/cong/tumr, sysi/epon, injr

proc, drug(N1A/2AB/C/3/4/7A/B/C/D)

M: VAS

anat(a:h/u/t/a/l,v:h/u/t/a/l)/phys/devp/cell/prot

noco/syva/cong/lyvd/tumr, sysi/epon, injr

proc, drug(C2s+n/3/4/5/7/8/9)

Lesions of spinal cord and brain

Spinal cord/
vascular myelopathy

sensory: Sensory ataxia · Tabes dorsalis

motor: Motor neurone disease

mixed: Brown-Séquard syndrome · cord syndrome (Posterior, Anterior, Central/Syringomyelia) · Subacute combined degeneration of spinal cord (B12) · Cauda equina syndrome

Anterior spinal artery syndrome

Brainstem

Medulla (CN 8, 9, 10, 12)	Lateral medullary syndrome/Wallenberg (PICA) · Medial medullary syndrome/Dejerine (ASA)

Pons (CN 5, 6, 7, 8)	Lateral pontine syndrome (AICA) (lateral) · Medial pontine syndrome/Millard-Gubler syndrome (basilar)/Foville's syndrome (dorsal, basilar) · Locked-in syndrome (ventral) · Internuclear ophthalmoplegia · One and a half syndrome

Midbrain (CN 3, 4)	Weber's syndrome (ventral peduncle, PCA) · Benedikt syndrome (ventral tegmentum, PCA) · Parinaud's syndrome (dorsal, tumor) · Nothnagel's syndrome · Claude's syndrome

Other	Alternating hemiplegia