The midbrain tegmentum is the core of the midbrain between the cerebral aqueduct and the substantia nigra. It is packed with important nuclei and pathways, including the red nucleus, oculomotor and trochlear nuclei, the reticular formation, the ventral tegmental area and the ascending sensory lemnisci.
| Location | Central midbrain, in front of the cerebral aqueduct and tectum, behind the substantia nigra and cerebral peduncles |
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| Parts |
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| Connections |
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| Blood Supply | Paramedian perforators from the basilar tip and posterior cerebral artery; Superior cerebellar artery; Posterior choroidal arteries |
Contains centres and pathways for eye movement, motor coordination, arousal, reward and sensory relay to the thalamus.
Lesions of the tegmentum produce syndromes such as Benedikt syndrome (third nerve palsy with contralateral tremor) and Claude syndrome (third nerve palsy with contralateral ataxia). Damage to the midbrain reticular formation can cause coma. Bilateral paramedian infarcts may cause vertical gaze palsy and reduced consciousness.
A tegmental midbrain lesion involving the oculomotor fascicles and red nucleus, causing same-side third nerve palsy and opposite-side tremor and involuntary movements.
A dorsal tegmental lesion damaging the oculomotor fascicles and cerebellar outflow, causing third nerve palsy with opposite-side ataxia.
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