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Parinaud's syndrome

About: Parinaud's syndrome is a research topic. Over the lifetime, 89 publications have been published within this topic receiving 807 citations. The topic is also known as: dorsal midbrain syndrome.


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Journal ArticleDOI
01 Dec 1982-Brain
TL;DR: The principal conclusion is that the riMLF efferent tracts mediating upward and downward gaze have clearly separate courses in the immediate premotor structures.
Abstract: Six cases of Parinaud's syndrome, with downward (Cases 1, 2), upward (Cases 3, 4) and both downward and upward gaze paralysis (cases 5, 6) are reported. Four cases (Cases 1, 2, 3, 5) were studied anatomically using serial sections of the brain and 3 cases (Cases, 1, 4, 6) analysed electro-oculographically. In all the cases there were rather small vascular lesions in the mesodiencephalic region, sparing the oculomotor nuclei. Since the rostral interstitial nuclei of the medial longitudinal fasciculus (riMLF), located above the oculomotor nuclei, contain the final relays producing all vertical saccades, it is suggested that the different aspects of Parinaud's syndrome may result from damage to their cells or to their excitatory efferent tracts, or even to their afferent pathways. Downgaze paralysis results from bilateral lesions involving the regions located just caudal, medial and dorsal to the upper poles of the red nuclei. The critical area is probably related to the mediocaudal part of the riMLF, the lateral portion of which appears to be spared. These anatomical data, combined with the clinical observation that most downward eye movements (except slow reflex movements) are affected in the case with such paralysis, lead us to propose that it is the riMLF efferent tracts mediating downgaze and projecting on to the oculomotor nuclei that are principally damaged by the lesions. Upgaze paralysis results from unilateral lesions in or near the posterior commissure. The clinical data allow us to propose that it is also the riMLF efferent tracts, mediating upgaze, that are damaged in such cases. consequently these tracts, probably originating from the dorsolateral part of the riMLF, would decussate through the posterior commissure before they reach the oculomotor nuclei. Combined downgaze and upgaze paralysis results from bilateral lesions involving the region related to the whole riMLF on both sides. The principal conclusion is that the riMLF efferent tracts mediating upward and downward gaze have clearly separate courses in the immediate premotor structures.

157 citations

Journal ArticleDOI
TL;DR: Surgical intervention with radical cyst removal is the treatment of choice for all symptomatic pineal cysts and Ventricular shunting should be reserved for patients with persistent hydrocephalus after cyst resection.
Abstract: The authors present a series of six patients with large symptomatic benign pineal cysts and review the 27 patients previously reported in the literature. Patients with symptomatic pineal cysts most often present with one of three syndromes: 1) paroxysmal headache with gaze paresis; 2) chronic headache, gaze paresis, papilledema, and hydrocephalus; or 3) pineal apoplexy with acute hydrocephalus. Surgical intervention with radical cyst removal is the treatment of choice for all symptomatic pineal cysts. Complete cyst removal is desirable; however, radical subtotal resection is appropriate if the cyst cannot be easily separated from the quadrigeminal plate. Ventricular shunting should be reserved for patients with persistent hydrocephalus after cyst resection.

91 citations

Journal ArticleDOI
TL;DR: To optimize orientation and operative exposure for aggressive resection, the authors approached pineal region tumors transtentorially with the patient in a semisitting position to document operative ocular morbidity referable to the brain stem as well as visual deficits secondary to occipital lobe retraction.
Abstract: ✓ To optimize orientation and operative exposure for aggressive resection, the authors approached pineal region tumors transtentorially with the patient in a semisitting position. In the current report, 12 consecutive patients were evaluated to document operative ocular morbidity referable to the brain stem as well as visual deficits secondary to occipital lobe retraction. Before craniotomy, ophthalmological findings related to dorsal midbrain dysfunction were evident in four of the 10 patients who had previously undergone ventricular shunting. The other patients developed a partial or complete Parinaud's syndrome in the early postoperative period and some suffered additional deficits such as cranial nerve palsies. These deficits improved to varying degrees in all patients. Although each had full visual fields preoperatively, an absolute or incomplete left homonymous hemianopsia developed in the immediate postoperative period. Such visual field deficits fully resolved over a variable period of time in 10 ...

78 citations

Journal ArticleDOI
01 Oct 2002-Brain
TL;DR: This work investigates how visual performance and the various components of the pupil response have been affected in subjects with damage to the dorsal midbrain (Parinaud's syndrome) and suggests that the site of integration of cortical signals in relation to pupil colour and grating responses and the generation of sleepiness-induced oscillations of the pupils do not rely on the normal functioning of pretectal nuclei that are involved in the light reflex response.
Abstract: In addition to light flux changes, it is well established that other stimulus attributes such as colour, spatial structure or movement can also cause a transient constriction of the pupil, even when the onset of the stimulus causes a net decrease in light flux level on the retina. Although experimental findings in human subjects with postgeniculate lesions show that the generation of such responses must involve the processing of stimulus attributes in extrastriate areas of the cortex, little is known about the site of integration of cortical signals into the pupillomotor pathway. We have investigated how visual performance and the various components of the pupil response have been affected in subjects with damage to the dorsal midbrain (Parinaud's syndrome). The results show that the probable destruction of the olivary pretectal nucleus and the nucleus of the optic tract has little or no effect on pupil grating or pupil colour responses. The light reflex response, on the other hand, is virtually abolished, with only a small residual component that is similar to the pupil grating response and may not require an afferent projection to the midbrain. These new findings suggest that the site of integration of cortical signals in relation to pupil colour and grating responses and the generation of sleepiness-induced oscillations of the pupil do not rely on the normal functioning of pretectal nuclei that are involved in the light reflex response.

73 citations

Journal ArticleDOI
TL;DR: Several cases are presented in which Parinaud's syndrome or upward gaze palsies were associated with hydrocephalus due to non-neoplastic aqueductal occlusion, and the importance of differentiating such cases from those of neoplastic origin and the value of third ventriculography are stressed.
Abstract: ✓ Several cases are presented in which Parinaud's syndrome or upward gaze palsies were associated with hydrocephalus due to non-neoplastic aqueductal occlusion. In some of these cases the ocular signs proved to be an early and reliable indicator of increased intraventricular pressure due to shunt malfunction. The possible mechanisms by which this phenomenon occurs are discussed. The importance of differentiating such cases from those of neoplastic origin and the value of third ventriculography are stressed.

51 citations

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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
20211
20204
20195
20185
20171
20163