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What is Bilateral Babinski sign is characteristic of: and explain in detail?
Ans. a. Pontine hemorrhage (Ref: Harrison 19/e p2583, 209, 18/e p3286-3287)Features of Pontine StrokeSudden onsetDeep coma with quadriplegia (usually occurs over few minutes)Pinpoint pupil (1 mm pupils) that react to lightLoss of reflex eye movements and corneal responsesDecerebrate rigidity/PosturingHyperpnea/HyperventilationSevere hypertensionOcular bobbingExcessive sweating/HyperhidrosisHyperpyrexiaPontine StrokesVentral pontine syndrome (Millard Gubler syndrome)Lower dorsal pontine syndrome (Foville's syndrome)Upper dorsal pontine syndrome (Raymond ceston syndrome)* Caused by paramedian infarction of pons* Caused by lesion is dorsal tegmentum of lower pons* Caused by obstruction of long circumferential branches of basilar artery