Brainstem
Last revised by Raymond Chieng on 6 May 2023
Citation, DOI, disclosures and article data
Citation:
Jones J, Chieng R, Hacking C, et al. Brainstem. Reference article, Radiopaedia.org (Accessed on 29 Nov 2023) https://doi.org/10.53347/rID-5793
rID:
5793
Article created:
22 Mar 2009, Jeremy Jones ◉
Disclosures:
At the time the article was created Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosuresLast revised:
6 May 2023, Raymond Chieng ◉
Disclosures:
At the time the article was last revised Raymond Chieng had no financial relationships to ineligible companies to disclose.
View Raymond Chieng's current disclosuresRevisions:
11 times, by 5 contributors - see full revision history and disclosures
Systems:
Sections:
The brainstem is the most caudal part of the brain. It adjoins, is structurally continuous with the spinal cord and consists of the:
midbrain (mesencephalon)
pons (part of the metencephalon)
medulla oblongata (myelencephalon)
The brainstem provides the main motor and sensory innervation to the face and neck via the cranial nerves. It also provides the connection of the cerebrum, basal ganglia, diencephalon, cerebellum and spinal cord. Additionally, there are other brainstem nuclei.
The brainstem also plays an important role in the regulation of cardiac and respiratory function. It also regulates the central nervous system and is pivotal in maintaining consciousness and regulating the sleep cycle.
Some taxonomies describe the brainstem as only containing the medulla oblongata and pons, whereas others include the midbrain.
Radiological features
Ultrasound
The brainstem structures can be seen by positioning the ultrasound probe against the squamous suture of the temporal bone or against the upper nuchal area using the foramen magnum as the window. Midbrain, pons, and medulla all appear hypoechoic on ultrasound. Hyperchoic brainstem may indicate pathology 7.
Quiz questions
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References
- 1. Susan Standring. Gray's Anatomy. ISBN: 9780702052309 https://drive.google.com/file/d/0BwQj92tZP0i3bEk5YmR0LUI1bFE/view?usp=sharing
- 2. Schünke M, Schulte E, Ross LM et-al. Head and Neuroanatomy. George Thieme Verlag. (2007) ISBN:3131421215. Read it at Google Books - Find it at Amazon
- 3. Butler P, Mitchell A, Healy JC. Applied Radiological Anatomy. Cambridge University Press. (2012) ISBN:0521766664. Read it at Google Books - Find it at Amazon
- 4. Last's anatomy, regional and applied. Churchill Livingstone. ISBN:044304662X. Read it at Google Books - Find it at Amazon
- 5. Murray Llewellyn Barr, John Alan Kiernan. The Human Nervous System. (1988)
- 6. A. R. Crossman, David Neary (MD.). Neuroanatomy. (1995)
- 7. Tu Y, Chen C, Lin Y, Chang Y, Huang C. Neonatal Neurological Disorders Involving the Brainstem: Neurosonographic Approaches Through the Squamous Suture and the Foramen Magnum. Eur Radiol. 2005;15(9):1927-33. doi:10.1007/s00330-005-2737-6 - Pubmed
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Articles:
- Brain
- Cerebral peduncles
- Hiccups
- Chiari I malformation
- Posterior circulation infarction
- Brainstem glioma
- Great cerebral vein
- Medulla oblongata
- Dorsal brainstem syndrome
- Tectal glioma
- Posterior choroidal arteries
- Pituitary fossa
- Grey matter
- Vertebral artery thrombosis
- Chiari 1.5 malformation
- Diffuse axonal injury (grading)
- Achondroplasia
- Anencephaly
- Möbius syndrome
- Spetzler-Martin arteriovenous malformation grading system
Cases:
- Maple syrup urine disease
- Bifocal meningioma
- Diabetic ketoacidosis-induced posterior reversible encephalopathy syndrome (PRES)
- Arterial tortuosity syndrome
- Pontine glioma
- Diffuse brainstem glioma
- Brainstem arterial territories (diagrams)
- Brainstem cross-sectional anatomy (diagrams)
- Brainstem tracts (Gray's illustrations)
- Decussation of fibres in the brainstem (Gray's illustration)
- Venous vascular territories of the medial cerebral cortex (illustration)
- Brainstem glioma
- Brainstem glioma
- Acute cerebellitis
- En plaque meningioma with associated CPA / frontal convexity meningiomas
- Acoustic neuroma with obstructive hydrocephalus
- Basilar artery occlusion - brainstem infarction
- Meningioma of the cerebellopontine angle
- Neonatal hypoxic-ischemic encephalopathy
- Brainstem glioma
Multiple choice questions:
Related articles: Anatomy: Brain
-
brain
- grey matter
- white matter
-
cerebrum
-
cerebral hemisphere (telencephalon)
- cerebral lobes and gyri
- frontal lobe
- parietal lobe
-
occipital lobe
- occipital pole
- lingual gyrus
- fusiform gyrus (Brodmann area 37)
- calcarine (visual) cortex
- cuneus
- temporal lobe
- basal forebrain
- limbic system
- insula
-
cerebral sulci and fissures (A-Z)
- calcarine fissure
- callosal sulcus
- central (Rolandic) sulcus
- cingulate sulcus
- collateral sulcus
- inferior frontal sulcus
- inferior occipital sulcus
- inferior temporal sulcus
- interhemispheric fissure
- intraparietal sulcus
- lateral (Sylvian) sulcus
- lateral occipital sulcus
- marginal sulcus
- occipitotemporal sulcus
- olfactory sulcus
- paracentral sulcus
- paraolfactory sulcus
- parieto-occipital fissure
- posterior parolfactory sulcus
- precentral sulcus
- preoccipital notch
- postcentral sulcus
- rhinal sulcus
- rostral sulcus
- subparietal sulcus
- superior frontal sulcus
- superior occipital sulcus
- superior temporal sulcus
- cortical histology
- cerebral lobes and gyri
- white matter tracts
- deep grey matter
-
pituitary gland
- posterior pituitary and stalk (part of diencephalon)
- anterior pituitary
- inferior hypophyseal arterial circle
- diencephalon
-
cerebral hemisphere (telencephalon)
-
brainstem
- midbrain (mesencephalon)
- pons (part of metencephalon)
- medulla oblongata (myelencephalon)
- white matter
-
grey matter
- non-cranial nerve
-
cranial nerve nuclei
- oculomotor nucleus
- Edinger-Westphal nucleus
- trochlear nucleus
- motor nucleus of CN V
- mesencephalic nucleus of CN V
- main sensory nucleus of CN V
- spinal nucleus of CN V
- abducent nucleus
- facial nucleus
- superior salivatory nucleus
- cochlear nuclei
- vestibular nuclei
- inferior salivatory nucleus
- solitary tract nucleus
- ambiguus nucleus
- dorsal vagal motor nucleus
- hypoglossal nucleus
-
cerebellum (part of metencephalon)
- vermis
- cerebellar hemisphere
- cerebellar peduncles
- cranial meninges (meninx primitiva)
- CSF spaces
-
cranial nerves (mnemonic)
- olfactory nerve (CN I)
- optic nerve (CN II)
- oculomotor nerve (CN III)
- trochlear nerve (CN IV)
- trigeminal nerve (CN V) (mnemonic)
- abducens nerve (CN VI)
- facial nerve (CN VII) (segments mnemonic | branches mnemonic)
-
vestibulocochlear nerve (CN VIII)
- vestibular ganglion (Scarpa's ganglion)
- glossopharyngeal nerve (CN IX)
- vagus nerve (CN X)
- spinal accessory nerve (CN XI)
- hypoglossal nerve (CN XII)
- functional neuroanatomy
- CNS development
- cerebral vascular supply
- arteries
- vascular territories
-
circle of Willis
- internal carotid artery (ICA) (segments)
- vertebral artery
-
normal variants
- intracranial arterial fenestration
- internal carotid artery (ICA)
- anterior cerebral artery (ACA)
- middle cerebral artery (MCA)
- posterior cerebral artery (PCA)
- basilar artery
- persistent carotid-vertebrobasilar artery anastomoses (mnemonic)
- vertebral artery
- ophthalmic artery
-
cerebral venous system
-
dural venous sinuses
- basilar venous plexus
- cavernous sinus (mnemonic)
- clival diploic veins
- inferior petro-occipital vein
- inferior petrosal sinus
- inferior sagittal sinus
- intercavernous sinus
- internal carotid artery venous plexus of Rektorzik
- jugular bulb
- marginal sinus
- occipital sinus
- sigmoid sinus
- sphenoparietal sinus
- straight sinus
- superior petrosal sinus
- superior sagittal sinus
- torcula herophili
- transverse sinus
-
cerebral veins
-
superficial veins of the brain
- superior cerebral veins (superficial cerebral veins)
- inferior cerebral veins
- superficial middle cerebral vein
- superior anastomotic vein (of Trolard)
- inferior anastomotic vein (of Labbe)
-
superficial veins of the brain
-
deep veins of the brain
- great cerebral vein (of Galen)
- venous circle of Trolard
- normal variants
-
dural venous sinuses
- arteries
- glymphatic pathway
