A 44yo pt comes with right hemiparesis. Exam: left sided ptosis and left dilated pupil. Where is
the lesion?
a. Cerebral infarct
b. Cerebellar infarct
c. Medulla oblongata
d. Pons
e. Midbrain
answer E
Weber syndrome is a midbrain stroke syndrome that involves the fascicles of the oculomotor nerve resulting in an ipsilateral CN III palsy and contralateral hemiplegia or hemiparesis.
Using imaging alone, it is difficult to distinguish Weber from Benedikt syndrome, unless clear involvement of the red nucleus can be identified (seen in the latter).
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