Weber syndrome is a midbrain stroke syndrome that involves the cerebral peduncle and the ipsilateral fascicles of the oculomotor nerve 1-3,5. Occasionally the substantia nigra can also be involved 5.
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Clinical presentation
- ipsilateral CN III palsy
- diplopia
- ptosis
- afferent pupillary defect
- contralateral hemiplegia or hemiparesis
- involvement of the corticospinal and/or corticobulbar tracts
- contralateral parkinsonian rigidity (only if substantia nigra involved) 5
Pathology
It is usually caused by an ischemic stroke, typically involving branches of the posterior cerebral artery 1-3.
Radiographic features
Imaging may be helpful to connect the neurological symptoms with a single causative lesion.
The imaging appearance of Weber and Benedikt syndromes may be similar, as both result from an insult to the oculomotor nuclear complex 1-3, however the latter syndrome also involves the red nucleus in the midbrain tegmentum.
History and etymology
The syndrome was first described by Sir Hermann Weber (1823-1918), a German-born English physician, in 1863 4.
