It involves oculomotor fascicles in the interpeduncular cisterns and cerebral peduncle so it characterizes the presence of an ipsilateral lower motor neuron type oculomotor nerve palsy and contralateral hemiparesis or hemiplegia.

[1][2] This lesion is usually unilateral and affects several structures in the midbrain including: Clinical findings mainly eyeball is down and out ipsilateral lateral squint.

Ptosis present as the levator palpebrae superioris nerve supply is disrupted.

Contralateral hemiplegia CT scan or MRI might help in delineating the cause or the vessel or region of brain involved in stroke.

[citation needed] It carries the name of Sir Hermann David Weber, a German-born physician working in London, who described the condition in 1863.