Today only I came accross this. Very clearly explained. Iam a victim of pontine Stroke . Recovered from most of the signs and symptoms of Locked In Syndrome. But still have a walking disability. Today I clearly understood what happened to me. Excellent. Thank u very much.
Hey there Zach, amazing content as usual. Would like to point out a correction. At 18:01 while discussing Raymond Sx, you describe it as Ipsilateral facial nerve palsy + Contralateral hemiplegia. However, afaik, it is Ipsilateral 6th nerve (abducens) palsy + c/l hemiplegia. Also, some authors have suggested two presentations of raymond Sx (with & without facial paresis). But all agree on the involvement of Abducens nerve. Hope you have a look at this. Thanks for the great video.
Very true. Classical Raymond syndrome could be with or without a Contralateral facial nerve palsy in addition to the defects you mentioned above chesslord. Zach you may consider editing the video {although I am not a techy,I think it's possible.. perhaps inserting a footnote at the time to make the correction or by inserting a video clip just after you had spoken about Raymond syndrome to correct the error;The clip may even be a power point slide); Besides,weldone as usual Zach (and the entire team)!!
Great presentation Zach(and team)👍 I would like to add- In Marie Foix syndrome,one could also have ipsilateral facial nerve palsy,Horner's syndrome,nystagmus and vomitting. Locked in syndrome has 2 other presentations apart from the classical presentation you described. There's the incomplete immobility variant in which there is some preservation of motor function and There's the complete immobility variant where in addition, there's also loss of vertical eye movement BUT preservation of cortical function demonstrated on EEG.
If i say u r intelligent it is not enough a lot of people r intelligent u r a born teacher u know how to teach what is first second third like so to be taught after having your lecture on the subject need not to open book your personality your voice your features all are beautiful your knowledge your delivery marvellous your qualities r beyond words your musical delivery just like a soothing song i m senior citizen of City Agra a homoeopathic physician u have made me new i have nothing to pay only wishes i wish u a healthy long prosperous life to u and to your family
Loved the brainstem videos...It's gud to c u back teaching... Really looking forward to ur future videos :D... Plz keep teaching neurology🤩🤩....U really make it much more simplified😄
What causes damage to the pons? 👍 This can happen because the blood vessels that supply blood to the pons and the rest of the brainstem are located in the back of the neck, and may become injured as result of neck trauma or sudden pressure or movements of the head or neck.
Yes, after I suffered a rotational (with) head impact injury, MRI found tiny hyperintensity where the left trigeminal nerve exits the pon and a very subtle lesion on the left middle cerebellar peduncles. I was so dizzy and nauseated and my left eye was spinning but drs are saying most likely white matter desease. No head injury. Nothing to see here.
Excellent presentation again. Need little correction of Raymond syndrome. PPRF is close to the abducens nucleus. Vertical gaze center is located at thalamomescencephalic junction.
In your video about Gluconeogenisis you said Acetyl CoA was allosteric stimulated of Pyruvate Carboxylase..but what I studied was it is obligatory activator.
Thank you for sharing, video was very informative, however you don't speak of what types of lesions there are in the pons. My 11 yr. old son has a "probable" capillary telangiectasia in the "central pons" with an adjacent vein traversing the adjacent pons to the prepontine cistern, 1.3 x 1.0 x 1.2 cm. I was waiting thru the whole video to hear "central pons" as well as the "prepontine cistern." We've seen three neurologists and they are 95% sure it's a CT. He gets his second brain mri on Apr. 9th. Would really love to know more about your thoughts on "types of lesion in the pons." My son has headaches, nausea and is always complaining of being hot.
Could you please explain me why in Millard gubler syndrome, corticobulber fibers are spared and only corticospinal fibers are involved? Anatomically that should not be.
Hello Zach, Thank you for the explanations, although most of this is over my head, I'm experiencing facial paralysis on the left side of my face and am fairly worried as with most of the physical problems I've had I can usually exorcise them away, I've had an MRI and a cat scan so, no stroke according to the doctors...another MRI for the neck in 9 days, I was wondering what I might expect them to find out. Thank you for posting.
@@emilybailey268 This is one of the things that the last doctor I saw yesterday said might be my problem, I also have Dysphagia and am going in for a barium swallow on the 8th of this month as I have lost a great deal of weight and can't swallow food and have trouble lifting my head and I'm being told to see a neurologist and a neurosurgeon. PS: I saw your reply and thought that perhaps I missed a pronoun somewhere along the way. Thank you for your reply.
I did a bit research. There are two types. Please find below the summary and reference: “To date, only a few cases of Raymond syndrome, commonly without facial involvement have been reported. To our knowledge, the current case, with facial involvement, is the second validation of the classic Raymond syndrome after an extensive MEDLINE search. We would, therefore, propose the concept of two types of Raymond syndrome: (1) the classic type, which may be produced by a lesion in the mid-pons involving the ipsilateral abducens fascicle and the non-decussated corticofacial and corticospinal fibers; and (2) the common type, which may be produced by a lesion involving the ipsilateral abducens fascicle and non-decussated corticospinal while sparing the corticofacial fibers.” [PMID: 22934209]
@@nathantan1635 Mostly in the DC-AC circuits courses. I'll be honest if you study and pay attention it starts to make sense and becomes easier the more you do it
Today only I came accross this.
Very clearly explained.
Iam a victim of pontine Stroke .
Recovered from most of the signs and symptoms of Locked In Syndrome. But still have a walking disability.
Today I clearly understood what happened to me.
Excellent.
Thank u very much.
Love your teaching method. This ONLY way to learn the syndromes is to understand them. Thank you for your work
You’re looking great Zach!!!
Ninja Nerd lectures are the best!!
Love ya guys! 💙💙
Pons lesion-
Ventropontine syndrome-
Ipsilateral facial nerve palsy.
Ipsilateral lateral rectus plasy.
Contralateral hemiplegia.
Foville syndrome-
Ipsilateral facial nerve palsy.
Ipsilateral lateral rectus palsy.
Contralateral hemiplegia.
Ipsilateral gaze palsy due to paramedian pontine nuclear reticular formation.
Artery invovled-
Paramedian branch of basilar artery.
Short circumferential and long branches of basilar artery.
Anterior inferior cerebellar artery.
Lateral pontine syndrome-
Marie foix syndrome-
Contralateral hemiplegia
Contralateral loss of crude touch pain temperature.
Ipsilateral ataxia cerebellar
Deafness.
Locked in syndrome-
Quadriplegia
Horizontal gaze palsy.
Bilateral internuclear opthalmoplegia.
Reticular formation is intact.
Pons lesion-
Vental pontine
Foville syndrome
Lateral pontine
Locked in
Thank you sir
Hey there Zach, amazing content as usual. Would like to point out a correction.
At 18:01 while discussing Raymond Sx, you describe it as Ipsilateral facial nerve palsy + Contralateral hemiplegia. However, afaik, it is Ipsilateral 6th nerve (abducens) palsy + c/l hemiplegia.
Also, some authors have suggested two presentations of raymond Sx (with & without facial paresis). But all agree on the involvement of Abducens nerve.
Hope you have a look at this. Thanks for the great video.
Yes ur correct ...I also noticed this now , raymond is 6 nerve with contralateral hemiplegia ..
Very true.
Classical Raymond syndrome could be with or without a Contralateral facial nerve palsy in addition to the defects you mentioned above chesslord.
Zach you may consider editing the video
{although I am not a techy,I think it's possible.. perhaps inserting a footnote at the time to make the correction or by inserting a video clip just after you had spoken about Raymond syndrome to correct the error;The clip may even be a power point slide); Besides,weldone as usual Zach (and the entire team)!!
Great presentation Zach(and team)👍
I would like to add-
In Marie Foix syndrome,one could also have ipsilateral facial nerve palsy,Horner's syndrome,nystagmus and vomitting.
Locked in syndrome has 2 other presentations apart from the classical presentation you described.
There's the incomplete immobility variant in which there is some preservation of motor function and
There's the complete immobility variant where in addition, there's also loss of vertical eye movement BUT preservation of cortical function demonstrated on EEG.
Searching entire TH-cam n got from the man i view frequently ☺️.
The best
specifically enjoyed ur explanation of locked in syndrome---what a masterpiece
If i say u r intelligent it is not enough a lot of people r intelligent u r a born teacher u know how to teach what is first second third like so to be taught after having your lecture on the subject need not to open book your personality your voice your features all are beautiful your knowledge your delivery marvellous your qualities r beyond words your musical delivery just like a soothing song i m senior citizen of City Agra a homoeopathic physician u have made me new i have nothing to pay only wishes i wish u a healthy long prosperous life to u and to your family
Thank you Prof Murphy. Coolest Professor every.
“Where the heck is that blue marker?”- lol! Thanks for teaching us Zach! Thank you Ninja Nerds!
Loved the brainstem videos...It's gud to c u back teaching...
Really looking forward to ur future videos :D...
Plz keep teaching neurology🤩🤩....U really make it much more simplified😄
I saw ur many lectures it's so helpful& as well as so easy to understand it & one thing more look fit😊😍😍
First time ever understand it...big respect 🙇♀️
Thanks a lot. You are saving my life 😊❤️
Marvellous presentations.Loved it.
19:28 Raymond syndrome- ipsilateral 6th nerver Palsy. 7th nerve spared..
You made lectures like a piece of cake 😎
Really helpful 👍
Lots of love and respect from Pakistan 🥰
Beautifully explained. Thanks zack
Sir you are an amazing teacher
Everybody's asking where is the lesion, but no-one is asking how is the lesion 😢
thanks for all second you are soend in this vedio, I hope give as more neurosurgery lecture
Excellent talk and teaching
Thanks
Did you know that one cannot breathe while smiling
Now I just made a person smile for no reason
F.u
Didn’t fall for it, but it’s very sweet of you.
I needed this...thanks a lot 🥺...now my neuroanatomy would be easier..😁
Yayyyy a lifesaver! God bless you! Thanx a million!
What causes damage to the pons?
👍
This can happen because the blood vessels that supply blood to the pons and the rest of the brainstem are located in the back of the neck, and may become injured as result of neck trauma or sudden pressure or movements of the head or neck.
Just the question i wanted to ask. Thanks :)
@@Echelon111999 👍❤
Yes, after I suffered a rotational (with) head impact injury, MRI found tiny hyperintensity where the left trigeminal nerve exits the pon and a very subtle lesion on the left middle cerebellar peduncles. I was so dizzy and nauseated and my left eye was spinning but drs are saying most likely white matter desease. No head injury. Nothing to see here.
I really love you much...... Your videos have helped me soooo much.... thanks a ton 😊😊😊.
Lock-in syndrome is a true tragic. My gramp & my patient had it, and it truly depressed me. Btw, your vid is great 👍🏻
I'm so sorry to hear that. It must be so difficult
CORRECTION: Raymond's syndrome has ipsilateral abducent nerve palsy, not facial nerve - checked various sources
thank you man for another awesome video!!
As always best video. Thank you so much.
In Millard-Gubler syndrome, shouldn’t there also be ipsilateral ataxia due to the lesion of the pontocerebellar fibers?
One of my favorite videos :)
Thank u sir also makes pharmacology lectures along with neuroanatomy lectures
Zach, watch out! Your biceps are almost ripping the sleeve off! Hahaha looking great man, congrats on your heathy life journey 💪
Excellent presentation again. Need little correction of Raymond syndrome. PPRF is close to the abducens nucleus. Vertical gaze center is located at thalamomescencephalic junction.
You are just amazing sir ❤️🙏 I never made wish to.meet someone. But yes I want to meet you somewhere sometimes in the life ❤️❤️ keep going❤️🇵🇰🇵🇰🇵🇰🇵🇰
Sir very nice lecture
Tysm for such great efforts 👏
you guys are awesome. love you
😇😇Thanks alot
You’re video is very very help me to understand 👌👌😍😍😍
Once 👏a👏gain👏! Doing God's work🔥
Well done❤️
Thank u sir, it's really really helpful
I love this ninja video..
Thank you so much ❤
Kindly upload the lecture about limbic system and reticular formation
In your video about Gluconeogenisis you said Acetyl CoA was allosteric stimulated of Pyruvate Carboxylase..but what I studied was it is obligatory activator.
If all teachers had a natural unintentional ASMR quality to them (like yourself) classes would be so much more manageable lmao
Thank you soo much sir 💕💕💕
Thanks a ton sir 🙏💐hats off...
💖LOVE YOU NINJA💖
Amino acid metabolism please 😘l😘😘
Can you please tell what will be the symptoms in cerebellar pontine stroke please
Thankx a lot,Sir.♥ :)
C'est parfait!
Biiiig love and respect 🙏🙏🙏🙏❤️❤️❤️
Amazing👍👍
Thank you very much...
Thanks 💛
Thank you for sharing, video was very informative, however you don't speak of what types of lesions there are in the pons. My 11 yr. old son has a "probable" capillary telangiectasia in the "central pons" with an adjacent vein traversing the adjacent pons to the prepontine cistern, 1.3 x 1.0 x 1.2 cm. I was waiting thru the whole video to hear "central pons" as well as the "prepontine cistern." We've seen three neurologists and they are 95% sure it's a CT. He gets his second brain mri on Apr. 9th. Would really love to know more about your thoughts on "types of lesion in the pons." My son has headaches, nausea and is always complaining of being hot.
Loved it
Tankful for you ❤️❤️
Thank you
Perfect 🤩
I have central pontine myelinolysis
Could you please explain me why in Millard gubler syndrome, corticobulber fibers are spared and only corticospinal fibers are involved? Anatomically that should not be.
Dude you are awsome how comes your channel is not lareger ???
I'm shairing it on fb
Zach ⚡⚡
Thank u sir u are awesome
Sweet Deal!
Thank u Sir
Thanks
Sir waiting for pharmacology lectures also
Are the sympathetic fibers not involved in the lateral pontine syndrome? I.e Horner syndrome.
Hei bro, i have a question. Gastric parietal cell contain which kind of muscarinic receptor? M3 or M1 ?
amazeballs!
I wonder if a pons lesion can cause pulsatile tinnitus on one side. I have both.
What causes this Millard gublar in anatomical background.
Thankyou so muchh
Hello Zach, Thank you for the explanations, although most of this is over my head, I'm experiencing facial paralysis on the left side of my face and am fairly worried as with most of the physical problems I've had I can usually exorcise them away, I've had an MRI and a cat scan so, no stroke according to the doctors...another MRI for the neck in 9 days, I was wondering what I might expect them to find out. Thank you for posting.
MS?
@@emilybailey268 This is one of the things that the last doctor I saw yesterday said might be my problem, I also have Dysphagia and am going in for a barium swallow on the 8th of this month as I have lost a great deal of weight and can't swallow food and have trouble lifting my head and I'm being told to see a neurologist and a neurosurgeon. PS: I saw your reply and thought that perhaps I missed a pronoun somewhere along the way. Thank you for your reply.
isn't raymond syndrome I/L abducens palsy and C/L hemiplegia ? like it is ventro"medial" ? Not sure please confirm . Thanks
I did a bit research. There are two types. Please find below the summary and reference: “To date, only a few cases of Raymond syndrome, commonly without facial involvement have been reported. To our knowledge, the current case, with facial involvement, is the second validation of the classic Raymond syndrome after an extensive MEDLINE search. We would, therefore, propose the concept of two types of Raymond syndrome: (1) the classic type, which may be produced by a lesion in the mid-pons involving the ipsilateral abducens fascicle and the non-decussated corticofacial and corticospinal fibers; and (2) the common type, which may be produced by a lesion involving the ipsilateral abducens fascicle and non-decussated corticospinal while sparing the corticofacial fibers.” [PMID: 22934209]
awesome
This guy is so cool, you could keep a side of beef in him for a week.
So med school students study all of this stuff?! Wow!
:))
Happy I choose Biomedical Engineering Technology. I mean damn dude
@@markanthony1004 Engineering has lots of high-level math though?
@@nathantan1635 Mostly in the DC-AC circuits courses. I'll be honest if you study and pay attention it starts to make sense and becomes easier the more you do it
😂
Raymond will involve abducens nerve I think
until next time ! ;)
How old are you zach?
Raymond syndrome:
C/L hemiplegia + 6th nerve palsy
(7th nerve is spared)
Spinal lemoniscus is lemony
❤❤❤❤
please add subtitles
👌👌👌
I really admire his drawing skills, that's awesome
P.S. If you are interested in biology ,you will probably find interesting stuff on my chanel
19:27
What a mistake ninja nerd !!!
It affects the ipsilateral abducent not facial nuclei
❤
In lateral pontine syndrome, there is no corticospinal fibers involvement
The lesions might extend in medial direction and affect few corticospinal tract fibres.
In raymond syndrome 6th nerve involved
❤️❤️👍