Brainstem and Cranial Nerves: Longitudinal Pathways of the Brainstem

This chapter reviews pathways that are not at a single level of the brainstem but rather involve multiple areas with supratentorial input. The chapter highlights autonomic pathways, the reticular formation and chemically defined groups, and coordination of eye movements. Sympathetic fibers travel from the hypothalamus to the intermediolateral column in the spinal cord through the lateral brainstem. Patients with a unilateral lesion of the lateral brainstem may have ipsilateral Horner syndrome. The ventrolateral medulla, also a sympathetic region of the brainstem, projects to the spinal cord and is involved in the innervation of blood vessels in the limbs.

Facial pain: a rare presenting symptom of sympathetic chain schwannoma

<p>Schwannoma is a nerve sheath tumour that usually presents as an asymptomatic lump. We report a case where facial pain was the only symptom of the tumour. Surgical excision was done. Intraoperative findings and Horner syndrome confirmed the diagnosis of cervical sympathetic chain schwannoma. Histopathology was also consistent with the diagnosis. The patient did well postoperatively.</p>

Iatrogenic Harlequin syndrome after thoracic spine surgery: a case report and literary review

Here we present a unique case of Harlequin syndrome without Horner syndrome after contralateral Th3 intradural tumor resection. Harlequin sign in our case presented probably to resection of sympathetic nerves while removing meningioma. Syndrome is rare in neurosurgical procedure, but we think that surgeons must be aware of it.