When a hemispheric lesion compresses the brainstem, the patient usually has signs or symptoms of hemisphere dysfunction, such as hemiparesis. Any space-occupying lesion, such as subdural hematoma, infarction, hemorrhage, or…
Coma Scales. The Glasgow Coma Scale score (see Section 14, Plate 14-15) for best motor response in either the upper or lower limbs is rated on a scale of 1…
The anatomic substrate for a disorder in consciousness is dysfunction in the reticular formation and the ascending reticular activating system (ARAS) because activation of the cerebral cortex during arousal and…
The thalamic perforating arteries may also hemorrhage. This often produces a thalamic syndrome similar to ischemic infarction. However, as the hemorrhage grows it may press downward on the midbrain, causing…
In addition, there are several cell groups along the midline and embedded in the internal medullary lamina (the intralaminar nuclei). These nuclei send projections more diffusely in the cerebral cortex,…
Patients with pituitary apoplexy present with severe headache of acute onset, which is typically considered as the worst headache ever experienced. Nausea and vomiting are very common. The rapid expansion…
To understand the development of postpartum pituitary infarction, one has to consider that the pituitary gland becomes hyperplastic (approximately doubling in mass) during pregnancy as a result of progressive lactotroph…
A wide variety of conditions may cause dysfunction of the hypothalamus or pituitary, leading to selective or universal, partial or complete, acute or chronic loss of adenohypophyseal hormone secretion (anterior…
Pituitary macroadenomas, which, by definition, exceed 10 mm in greatest diameter, may cause multiple anterior pituitary hormone deficiencies but only rarely cause diabetes insipidus preoperatively. In contrast, large suprasellar tumors…
