Cortical motor area (precentral gyrus): forms most of the pyramidal tract; controls voluntary movement of the contralateral half of the body ("inverted human shape")

Premotor area (in front of the precentral gyrus): Extrapyramidal cortical center; related to joint movement, postural adjustment, co-motor movement, autonomic nervous function, and muscle tone inhibition

Cortical lateral vision center/eye gaze center (posterior middle frontal gyrus): controls the same direction (contralateral) lateral gaze movement of both eyes

Writing center (posterior middle frontal gyrus of dominant hemisphere): adjacent to the cortical motor area that controls the hand

Motor speech center/Broca’s area (upper Sylvian fissure and posterior inferior frontal gyrus): controls speech movement

Prefrontal lobe: extensive contact fibers; related to memory, judgment, abstract thinking, emotion, and impulsive behavior

Lateral surface: seen in cerebral infarction, tumors, and trauma

Medially: seen in anterior cerebral artery occlusion and parasagittal sinus meningiomas; posterior paracentral lobular lesions can cause paralysis of the contralateral side below the knee (compared to spinal cord lesions, there is no paralysis above the knee)

Bottom surface: seen in contusion, olfactory groove meningioma, sphenoid crest meningioma

Cortical sensory area (postcentral gyrus): receives the deep and shallow sensations of the contralateral limb ("inverted human shape"); the parietal lobule is the cortical center for touch and entity sensation

Application center (dominant supramarginal gyrus): related to complex movements and labor skills

Visual language center/reading center (angular gyrus)

Postcentral gyrus and superior parietal lobule

Infraparietal lobule (supramarginal and angular gyrus)

Sensory speech center/Wernicke’s area: angular gyrus and posterior superior temporal gyrus

Auditory center: middle part of superior temporal gyrus, transverse temporal gyrus

Olfactory center: uncus and anterior part of hippocampus

Anterior temporal lobe: related to high-level neural activities such as memory, association, comparison, etc.

Mesial surface of temporal lobe: belongs to limbic system, including hippocampus

Lesions in the posterior superior temporal gyrus of the dominant hemisphere: sensory aphasia

Lesions in the posterior middle temporal gyrus of the dominant hemisphere: naming aphasia

Uncinus lesions: phantom smells, phantom tastes, tongue licking, chewing movements (uncus seizures)

Hippocampal lesions: epilepsy, delusions, hallucinations, automatisms, déjà vu, emotional abnormalities, psychosis, visceral symptoms/convulsions, severe recent memory impairment

Extensive damage to the temporal lobe of the dominant hemisphere/bilateral temporal lobe damage: psychiatric symptoms (personality changes, abnormal mood, memory impairment, mental retardation, indifferent expression)

Deep optic radiation fiber/optic tract damage in the temporal lobe: homonymous hemianopia in the contralateral visual fields of both eyes

Visual center

Lesions around the visual center of the dominant hemisphere: visual agnosia (not blind, but losing the ability to distinguish shapes, faces, and colors, and sometimes requiring the help of touch to identify)

Parieto-occipital junction area lesions: visual distortion (sometimes a precursor to epilepsy)

Ventral nucleus group: ventroanterior nucleus → regulates body movement; ventrolateral nucleus → regulates extrapyramidal motor coordination; ventroposterolateral nucleus → spinothalamic tract & medial lemniscus (body/limb sensation); ventroposteromedial nucleus → Trigeminal system (facial sense of taste); medial geniculate body → hearing; lateral geniculate body → vision

Dorsal nucleus group

Thalamus pain: ①Characteristics: The pain location is diffuse and not fixed, the nature of the pain is difficult to describe, the pain can be aggravated by various emotional stimuli, and is often accompanied by autonomic nervous system dysfunction (such as increased blood pressure and blood sugar)

Manifestations: ① Dizziness, nausea, vomiting, nystagmus → damage to the vestibular nerve nucleus; ② Paralysis of the soft palate/pharyngeal muscles on the affected side (dysphagia, dysphonia, drooping of the ipsilateral soft palate, loss of gag reflex) → nucleus ambiguus/glossopharyngeal nerve /Vagus nerve damage; ③ Ataxia on the affected side → Damage to the funicular body/spinocerebellar tract/part of the cerebellar hemisphere; ④ Horner syndrome on the affected side → Damage to the descending sympathetic fibers; ⑤ Crossed sensory disorder (loss of pain and temperature sensation on the same side of the face , loss of pain and temperature sensation on the contralateral hemisphere) → damage to the spinal nucleus of the trigeminal nerve and damage to the lateral spinothalamic tract

Seen in: obstruction of posterior inferior cerebellar artery, vertebrobasilar artery, lateral medullary artery

Manifestations: ① Paralysis and atrophy of the tongue muscle on the affected side → hypoglossal nerve damage; ② Central paralysis of the upper and lower limbs on the contralateral side → damage to the pyramidal tract; ③ Hyposensation/loss of deep sensation on the contralateral side → damage to the medial lemniscus

Seen in: vertebral artery and its branches, basilar artery posterior vascular obstruction in the pons

Manifestations: ① Inability to abduct the eyeball on the affected side, peripheral facial paralysis → abducens nerve palsy, damage to the facial nerve nucleus; ② Central hemiplegia on the contralateral side → damage to the pyramidal tract; ③ Sensory disorder on the contralateral side → medial lemniscus, spinothalamic tract damage

Seen in: obstruction of the inferior anterior cerebellar artery

Manifestations: ① Inability to abduct the eyeball on the affected side, peripheral facial paralysis → abducens nerve palsy, and damage to the facial nerve nucleus; ② Both eyes gaze to the opposite side → damage to the lateral visual center and medial longitudinal fasciculus of the pons; ③ Central hemiplegia on the contralateral side → pyramidal beam damage

Seen in: paramedian pontine artery occlusion

Manifestations: ① Dizziness, nausea, vomiting, nystagmus → damage to the vestibular nerve nucleus; ② Inability to abduct the eyeball on the affected side → abducens nerve paralysis; ③ Paralysis of the affected side → damage to the facial nerve nucleus; ④ Horner syndrome on the affected side → descending sympathetic fibers Damage; ⑤ Ipsilateral hemitaxia → damage to the middle cerebellar peduncle, inferior cerebellar peduncle and spinocerebellar anterior bundle; ⑥ Crossed sensory disorder; ⑦ Gaze to the opposite side → damage to the pontine lateral visual center and medial longitudinal fasciculus; ⑧ Right Hypoesthesia/loss of deep body hemisphere→medial lemniscus damage

Seen in: superior cerebellar artery/inferior anterior artery obstruction

Manifestations: clear consciousness, no obstacle in language understanding, bilateral central paralysis, only able to move the eyes up and down, horizontal eye movement disorder, unable to speak, bilateral facial paralysis, tongue, pharynx, articulation, and swallowing movement disorders, unable to turn Neck shrug, may have bilateral pathological reflexes, often mistaken for coma (but EEG is normal)

Seen in: Bilateral occlusion of the pontine branches of the basilar artery → Bilateral corticospinal tracts and cortical brainstem tracts innervating the trigeminal nerve are affected

Manifestations: ① Paralysis of all ophthalmic muscles except the rectus and superior oblique muscles on the affected side, mydriasis → oculomotor nerve palsy; ② Central facial and tongue paralysis on the contralateral side, paralysis of the upper and lower limbs → pyramidal tract damage

Seen in: Tentorial hiatal hernia

Manifestations: ① Loss of pupillary light reflex (superior colliculus); ② Vertical eye movement disorder (especially upward gaze) (superior colliculus); ③ Nervous deafness (inferior colliculus); ④ Cerebellar ataxia (combined brachial ataxia) )

Seen when tumors (such as pineal tumors) compress the midbrain quadrigemium (ie, tectum)