Clinically probable brainstem stroke presenting primarily as dysphagia and nonvisualized by MRI

Gasperini syndrome (GS), a rare brainstem syndrome, is featured by ipsilateral cranial nerves (CN) V–VIII dysfunction with contralateral hemibody hypoesthesia. While there have been 18 reported cases, the GS definition remains ambiguous. We report a new case and reviewed the clinical features of this syndrome from all published reports to propose a new definition. A 57-year-old man with acute brainstem stroke had right CN V–VIII and XII palsies, left body hypoesthesia and ataxia. Brain MRI showed an acute stroke in the right caudal pons and bilateral cerebellum. After a systematic review, we classified the clinical manifestations into core and associate features based on the frequencies of occurring neurological deficits. We propose that a definitive GS requires the presence of ipsilateral CN VI and VII palsies, plus one or more of the other three core features (ipsilateral CN V, VIII palsies and contralateral hemibody hemihypalgesia). Additionally, GS, similar to Wallenberg’s syndrome, represents a spectrum that can have other associated neurological features. The revised definition presented in this study may enlighten physicians with the immediate recognition of the syndrome and help improve clinical localization of the lesions and its management.

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Surface Electromyographic Characteristics of Swallowing in Dysphagia Secondary to Brainstem Stroke

Dysphagia ◽

10.1007/pl00009534 ◽

1997 ◽

Vol 12 (4) ◽

pp. 180-187 ◽

Cited By ~ 51

Author(s):

Michael A. Crary ◽

Brent O. Baldwin

Keyword(s):

Brainstem Stroke

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Reduced functional network connectivity is associated with upper limb dysfunction in acute ischemic brainstem stroke

Brain Imaging and Behavior ◽

10.1007/s11682-021-00554-0 ◽

2021 ◽

Author(s):

Wen Geng ◽

Juan Zhang ◽

Song’an Shang ◽

Huiyou Chen ◽

Mengye Shi ◽

...

Keyword(s):

Upper Limb ◽

Network Connectivity ◽

Functional Network ◽

Functional Network Connectivity ◽

Brainstem Stroke ◽

Upper Limb Dysfunction

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Acute Vertigo with Double Vision – Brainstem Stroke or Stroke Mimic?

Cerebrovascular Diseases ◽

10.1159/000320256 ◽

2010 ◽

Vol 30 (6) ◽

pp. 626-627 ◽

Cited By ~ 1

Author(s):

Regina Schlaeger ◽

Yvonne Naegelin ◽

Antje Welge-Lüssen ◽

Dominik Straumann ◽

Achim Gass ◽

...

Keyword(s):

Double Vision ◽

Brainstem Stroke ◽

Stroke Mimic

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Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis

Cureus ◽

10.7759/cureus.11114 ◽

2020 ◽

Author(s):

Javier A Ivona

Keyword(s):

Circle Of Willis ◽

Brainstem Stroke

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Abstract WP195: Cerebellar Magnetic Stimulation for Long-Lasting Dizziness After Brainstem Stroke

Stroke ◽

10.1161/str.50.suppl_1.wp195 ◽

2019 ◽

Vol 50 (Suppl_1) ◽

Author(s):

Ken Johkura ◽

Yosuke Kudo ◽

Eriko Sugawara ◽

Kazumitsu Amari ◽

Masahiro Yamamoto

Keyword(s):

Magnetic Stimulation ◽

Brainstem Stroke

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Neurological emergencies

Oxford Handbook of Acute Medicine ◽

10.1093/med/9780198797425.003.0006 ◽

2019 ◽

pp. 347-468

Author(s):

Punit S. Ramrakha ◽

Kevin P. Moore ◽

Amir H. Sam

Keyword(s):

Cord Compression ◽

Acute Bacterial Meningitis ◽

Raised Intracranial Pressure ◽

Limb Weakness ◽

Neurological Emergencies ◽

Transient Ischaemic Attacks ◽

Brainstem Stroke ◽

Brainstem Function ◽

Confusional States ◽

Space Occupying Lesion

This chapter discusses neurological emergencies, including coma, limb weakness, acute dizziness, acute loss of vision, painful red eye, acute bacterial meningitis, acute viral encephalitis, head injury, raised intracranial pressure (ICP), intracranial space-occupying lesion, haemorrhage (intracerebral, extradural, subdural, subarachnoid), status epilepticus (tonic–clonic), stroke, cerebral infarction syndromes, brainstem stroke, cerebellar stroke, transient ischaemic attacks (TIAs), confusional states and delirium, acute alcohol withdrawal, neuromuscular respiratory failure, myasthenic crises, spinal cord compression, Guillain–Barré syndrome (GBS), botulism, tetanus, the Glasgow Coma Scale (GCS), examination of brainstem function, and brain death.

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