| Claude's syndrome | |
|---|---|
| Specialty | Neurology  |
Claude's syndrome is a form of brainstem stroke syndrome characterized by the presence of an ipsilateral oculomotor nerve palsy, contralateral hemiparesis, contralateral ataxia, and contralateral hemiplegia of the lower face, tongue, and shoulder. Claude's syndrome affects oculomotor nerve, red nucleus and brachium conjunctivum. [1]
Claude's syndrome is caused by midbrain infarction as a result of occlusion of a branch of the posterior cerebral artery. [2] This lesion is usually a unilateral infarction of the red nucleus and cerebellar peduncle, affecting several structures in the midbrain including:
| Structure damaged | Effect |
|---|---|
| dentatorubral tract fibers | contralateral ataxia |
| corticospinal tract fibers | contralateral hemiparesis |
| corticobulbar tract fibers | contralateral hemiplegia of lower facial muscles, tongue, and shoulder |
| oculomotor nerve fibers | ipsilateral oculomotor nerve palsy with a drooping eyelid and fixed wide pupil pointed down and out; probable diplopia |
It is very similar to Benedikt's syndrome.
It has been reported that posterior cerebral artery stenosis can also precipitate Claude's syndrome. [3]
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It carries the name of Henri Charles Jules Claude, a French psychiatrist and neurologist, who described the condition in 1912. [4]
Articles related to anatomy include:
The brainstem is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is continuous with the thalamus of the diencephalon through the tentorial notch, and sometimes the diencephalon is included in the brainstem.
The oculomotor nerve is the third cranial nerve. It enters the orbit through the superior orbital fissure and innervates extrinsic eye muscles that enable most movements of the eye and that raise the eyelid. The nerve also contains fibers that innervate the intrinsic eye muscles that enable pupillary constriction and accommodation. The oculomotor nerve is derived from the basal plate of the embryonic midbrain. Cranial nerves IV and VI also participate in control of eye movement.
The trochlear nerve, also called the fourth cranial nerve or CN IV, is a motor nerve that innervates just one muscle: the superior oblique muscle of the eye, which operates through the pulley-like trochlea.
The fibers of the oculomotor nerve arise from a nucleus in the midbrain, which lies in the gray substance of the floor of the cerebral aqueduct and extends in front of the aqueduct for a short distance into the floor of the third ventricle. From this nucleus the fibers pass forward through the tegmentum, the red nucleus, and the medial part of the substantia nigra, forming a series of curves with a lateral convexity, and emerge from the oculomotor sulcus on the medial side of the cerebral peduncle.
Lateral medullary syndrome is a neurological disorder causing a range of symptoms due to ischemia in the lateral part of the medulla oblongata in the brainstem. The ischemia is a result of a blockage most commonly in the vertebral artery or the posterior inferior cerebellar artery. Lateral medullary syndrome is also called Wallenberg's syndrome, posterior inferior cerebellar artery (PICA) syndrome and vertebral artery syndrome.
The medial longitudinal fasciculus (MLF) is one of a pair of crossed over tracts, on each side of the brainstem. These bundles of axons are situated near the midline of the brainstem and are made up of both ascending and descending fibers that arise from a number of sources and terminate in different areas. The MLF is the main central connection for the oculomotor nerve, trochlear nerve, and abducens nerve. The vertical gaze center is at the rostral interstitial nucleus (riMLF).
Medial medullary syndrome, also known as inferior alternating syndrome, hypoglossal alternating hemiplegia, lower alternating hemiplegia, or Dejerine syndrome, is a type of alternating hemiplegia characterized by a set of clinical features resulting from occlusion of the anterior spinal artery. This results in the infarction of medial part of the medulla oblongata.
The corticobulbartract is a two-neuron white matter motor pathway connecting the motor cortex in the cerebral cortex to the medullary pyramids, which are part of the brainstem's medulla oblongata region, and are primarily involved in carrying the motor function of the non-oculomotor cranial nerves. The corticobulbar tract is one of the pyramidal tracts, the other being the corticospinal tract.
Brain herniation is a potentially deadly side effect of very high pressure within the skull that occurs when a part of the brain is squeezed across structures within the skull. The brain can shift across such structures as the falx cerebri, the tentorium cerebelli, and even through the foramen magnum. Herniation can be caused by a number of factors that cause a mass effect and increase intracranial pressure (ICP): these include traumatic brain injury, intracranial hemorrhage, or brain tumor.
The anterior choroidal artery originates from the internal carotid artery. However, it may (rarely) arise from the middle cerebral artery.
The posterior cerebral artery (PCA) is one of a pair of arteries that supply oxygenated blood to the occipital lobe, part of the back of the human brain. The two arteries originate from the distal end of the basilar artery, where it bifurcates into the left and right posterior cerebral arteries. These anastomose with the middle cerebral arteries and internal carotid arteries via the posterior communicating arteries.
The anterior inferior cerebellar artery (AICA) is one of three pairs of arteries that supplies blood to the cerebellum.
The superior cerebellar artery (SCA) arises near the termination of the basilar artery.
Weber's syndrome, also known as midbrain stroke syndrome or superior alternating hemiplegia, is a form of stroke that affects the medial portion of the midbrain. It involves oculomotor fascicles in the interpeduncular cisterns and cerebral peduncle so it characterizes the presence of an ipsilateral lower motor neuron type oculomotor nerve palsy and contralateral hemiparesis or hemiplegia.
Posterior cerebral artery syndrome is a condition whereby the blood supply from the posterior cerebral artery (PCA) is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel: the occipital lobe, the inferomedial temporal lobe, a large portion of the thalamus, and the upper brainstem and midbrain.
Benedikt syndrome, also called Benedikt's syndrome or paramedian midbrain syndrome, is a rare type of posterior circulation stroke of the brain, with a range of neurological symptoms affecting the midbrain, cerebellum and other related structures.
Posterior circulation infarct (POCI) is a type of cerebral infarction affecting the posterior circulation supplying one side of the brain.
A brainstem stroke syndrome falls under the broader category of stroke syndromes, or specific symptoms caused by vascular injury to an area of brain. As the brainstem contains numerous cranial nuclei and white matter tracts, a stroke in this area can have a number of unique symptoms depending on the particular blood vessel that was injured and the group of cranial nerves and tracts that are no longer perfused. Symptoms of a brainstem stroke frequently include sudden vertigo and ataxia, with or without weakness. Brainstem stroke can also cause diplopia, slurred speech and decreased level of consciousness. A more serious outcome is locked-in syndrome.
In neuroanatomy, corticomesencephalic tract is a descending nerve tract that originates in the frontal eye field and terminate in the midbrain. Its fibers mediate conjugate eye movement.
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