In the rule of 4 there are 4 rules:
There are 4 structures in the 'midline' beginning with M. There are 4 structures to the side beginning with S. There are 4 cranial nerves in the medulla, 4 in the pons and 4 above the pons (2 in the midbrain).
Excerpt. The trochlear nerve is the fourth cranial nerve (CN IV) and one of the ocular motor nerves that controls eye movement. The trochlear nerve, while the smallest of the cranial nerves, has the longest intracranial course as it is the only nerve to have a dorsal exit from the brainstem.
Your brainstem connects your brain to your spinal cord. It sits near the bottom of your brain. It helps regulate vital body functions that you don't have to think about, like breathing and your heart rate. Your brainstem also helps with your balance, coordination and reflexes.
Your brainstem is a stalk-like structure that connects your brain to your spinal cord. Lesions on your brainstem can cause problems with your heart rhythm, breathing, blood pressure, eye alignment and more.
A brain stem stroke can also cause double vision, slurred speech and decreased consciousness. Only a half-inch in diameter, the brain stem controls all basic activities of the central nervous system: consciousness, blood pressure and breathing. All motor control for the body flows through it.
Unlike other tissues in the body, neural tissue, or the tissue that makes up the brain stem, has a limited ability to heal. While some degree of regeneration or repair can occur, it may not fully restore function, especially in cases of severe injury.
The brainstem is the most evolutionarily conserved structure within brain. As such, it is the control center for the autonomic nervous system, which regulates basic life-sustaining activities such as heart rate, blood pressure, and respiration.
The medulla is essential to survival. Functions of the medulla regulate many bodily activities, including heart rhythm, breathing, blood flow, and oxygen and carbon dioxide levels. The medulla produces reflexive activities such as sneezing, vomiting, coughing and swallowing.
Effects of a Cranial Nerve 4 Palsy
Inability to move the eye down and in toward the nose. Double vision (because the two eyes are not pointed in the same direction). This double vision is vertical and torsional (tilted) Tilting of the head to compensate for the double vision.
Main arterial trunks supplying the brainstem include the vertebral artery, anterior spinal artery, posterior inferior cerebellar artery, basilar artery, anterior inferior cerebellar artery, superior cerebellar artery, posterior cerebral artery, posterior communicating artery, and anterior choroidal artery.
It is called so because the paralysis of this nerve causes deviation of eye making the patient do a head tilt to fuse two images (formed by the normal eye and the abnormally deviated eye) and thus giving the patient a “dejected” or “pathetic” look ! Thankfully ,this nomenclature has now been abandoned !
The “rule of four” is the Supreme Court's practice of granting a petition for review only if there are at least four votes to do so.
On the face of it, the Supreme Court's “Rule of Four” is straightforward. Where the justices have discretion as to whether to hear an appeal, at least four of the Court's members must vote to grant a writ of certiorari, which facilitates a full review on the merits.
The rule of four is a US Supreme Court practice that permits four of the nine justices to grant a writ of certiorari. It has the specific purpose to prevent a majority of the Court's members from controlling their docket.
In infants, the brainstem is not fully developed, and as such, various factors can override brainstem control of breathing. This includes factors such as hypoxemia (low oxygen levels), hypercapnia (high carbon dioxide levels), pain, fear, and anxiety.
The brainstem controls numerous vital body functions (breathing, swallowing, and vasomotor control over BP). Additionally, except for vision (CN2) and smell (CN1), all of the cranial nerves originate from the brainstem.
Your medulla oblongata is the bottom-most part of your brain. Its location means it's where your brain and spinal cord connect, making it a key conduit for nerve signals to and from your body. It also helps control vital processes like your heartbeat, breathing and blood pressure.
However, that person won't ever regain consciousness or start breathing again. Once the brain stem has permanently stopped functioning, there's no way of reversing it and the heart will eventually stop beating, even if a ventilator continues to be used.
If there has only been mild or short-lived anoxia, there may well be recovery back to a normal or near normal level of functioning. However, if the anoxic injury has been more marked the outcome is less certain and there are likely to be long-term effects.
They may open their eyes and sleep and breathe normally, but show no signs of awareness. This is sometimes called a vegetative state. If someone has more signs of conscious awareness, like being able to respond to a command or communicate at times, this can be called a minimally conscious state.
Common Symptoms of Brainstem Stroke
Symptoms can vary depending on where the stroke occurs, but they might include problems with balance, dizziness, trouble swallowing or speaking, and weakness on one side of the body.
There's no treatment to make a vegetative state get better. People sometimes recover a bit on their own depending on what their original problem was and how severe it was. People don't come back to normal, but a few relearn how to talk and understand people.
Brainstem encephalitis (BE) is a relatively rare, severe, and rapidly progressive inflammation of the brainstem. 1 This challenging entity is largely associated with infectious and autoimmune causes.