title: Cerebrovascular brainstem diseases with isolated cranial nerve palsies.
abstract: There is a significant number of individual patients with cranial nerve palsies as the sole manifestation of MRI- and, less frequently, CT-documented small brainstem infarctions or hemorrhages. The 3rd and 6th nerves are most commonly involved and, less frequently, the 4th, 5th, 7th, and 8th nerves. An intra-axial basis for such lesions may be underestimated if the diagnosis is based solely on MRI. The electrophysiologic abnormalities indicating brainstem lesions may be independent of MRI-documented morphological lesions. This paper reviews the literature on cerebrovascular brainstem diseases manifesting as isolated cranial nerve palsies. It supports the concept that small pontine and mesencephalic infarctions are the main cause of non-traumatic cranial nerve palsies in the middle-aged and elderly population. Microvascular infarction of the respective extra-axial cranial nerve segments seem to be less important.
authors.affiliation: Department of Neurology, University of Mainz, Germany. thoemke@neurologie.klinik.uni-mainz.de
authors.forename: Frank
authors.initials: F
authors.lastname: Thömke
authors.forename: Ludwig
authors.initials: L
authors.lastname: Gutmann
authors.forename: Peter
authors.initials: P
authors.lastname: Stoeter
authors.forename: Hanns Christian
authors.initials: HC
authors.lastname: Hopf
mesh_terms: D001933:Brain Stem / Q000098:blood supply* / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000150:complications*; D003389:Cranial Nerve Diseases / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging