tumor of Pineal Gland (Pinealoma) causes Parinaud Syndrome (vertical gaze palsy)
Location - Dorsal midbrain.
Parinaud syndrome—vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus.
Causes - Stroke, hydrocephalus, pinealoma.
I think the question stem may have a mistake because according to FA (2021 p. 528), Parinaud causes light-near dissociation wherein the light pupillary reflex is impaired while accommodation is intact. The question said accommodation is impaired...Anyway, pineal gland tumor fits the best.
submitted by ∗sunshinesweetheart(112)
some fun facts 4 u hoes to rule out the wrong answers:
Arcuate nucleus aka “infundibular nucleus” = hypothalamic nucleus. Projects dopaminergic neurons to anterior pituitary gland --> inhibits PRL. One of the 4 main dopamine pathways of the brain. Prolactin also gives feedback and inr dopamine secretion via this pathway [p 487 FA 2019]
Frontal cortex = oligodendrioma [p 514 FA 2019] rare, slow growing, fried egg appearance, may present with seizures
pituitary adenoma [p 514 FA 2019] - Bitemporal hemianopia - Most commonly a prolactinoma (hyperplasia of lactotrophs) - Male: decr libido, infertility - Female: galactorrhea, amenorrhea (PRL negative feedback on hypothalamic GnRH) - Can also see hyperplasia of somatotrophs (GH) --> acromegaly, gigantism or corticotrophs --> Cushing disease
PPRF = in charge of eye movements/conjugate gaze [p 503 FA 2019] - A stroke by the basilar artery of circular willis will lead to loss of horizontal, but not vertical eye movements