A Case of Progressive Stroke on Posterior Circulation with Transient Bilateral Oculomotor Palsy

Infarction located in the midbrain and pons presents various ophthalmic symptoms, because of the damage of the nuclei that control the movement of internal and external ocular and palpebral muscles. We experienced a case which presented with rare ocular symptoms and course. A 61-year-old man present...

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Autor principal: Takahashi, Chiaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5892245/
https://www.ncbi.nlm.nih.gov/pubmed/29785312
http://dx.doi.org/10.1155/2018/1579426
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author Takahashi, Chiaki
author_facet Takahashi, Chiaki
author_sort Takahashi, Chiaki
collection PubMed
description Infarction located in the midbrain and pons presents various ophthalmic symptoms, because of the damage of the nuclei that control the movement of internal and external ocular and palpebral muscles. We experienced a case which presented with rare ocular symptoms and course. A 61-year-old man presented with left hemiparesis and dysarthria, bilateral ptosis, and bilateral impaired eyeball movement: right eyeball movement was totally impaired and left could only perform slight adduction. MRI showed fresh stroke in the right thalamus, cerebral crus, and posterior lobe and cuneate lesion on bilateral paramedian portion of the midbrain. MRA showed occlusion in the P1 area of the posterior cerebral artery (PCA). Transesophageal echocardiography (TEE) showed findings of a patent foramen ovale (PFO). These findings suggested cardioembolic stroke as a cause of PCA occlusion and we prescribed rivaroxaban. The patient's eyeball and eyelid movement, only on the left side, was improved imperfectly 2 weeks later. We thought that neurological findings and course of this case may have arisen from dysfunction of the oculomotor nucleus and oculomotor fascicles, and MLF results from the presence of the lesion in paramedian midbrain and pons.
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spelling pubmed-58922452018-05-21 A Case of Progressive Stroke on Posterior Circulation with Transient Bilateral Oculomotor Palsy Takahashi, Chiaki Case Rep Neurol Med Case Report Infarction located in the midbrain and pons presents various ophthalmic symptoms, because of the damage of the nuclei that control the movement of internal and external ocular and palpebral muscles. We experienced a case which presented with rare ocular symptoms and course. A 61-year-old man presented with left hemiparesis and dysarthria, bilateral ptosis, and bilateral impaired eyeball movement: right eyeball movement was totally impaired and left could only perform slight adduction. MRI showed fresh stroke in the right thalamus, cerebral crus, and posterior lobe and cuneate lesion on bilateral paramedian portion of the midbrain. MRA showed occlusion in the P1 area of the posterior cerebral artery (PCA). Transesophageal echocardiography (TEE) showed findings of a patent foramen ovale (PFO). These findings suggested cardioembolic stroke as a cause of PCA occlusion and we prescribed rivaroxaban. The patient's eyeball and eyelid movement, only on the left side, was improved imperfectly 2 weeks later. We thought that neurological findings and course of this case may have arisen from dysfunction of the oculomotor nucleus and oculomotor fascicles, and MLF results from the presence of the lesion in paramedian midbrain and pons. Hindawi 2018-03-26 /pmc/articles/PMC5892245/ /pubmed/29785312 http://dx.doi.org/10.1155/2018/1579426 Text en Copyright © 2018 Chiaki Takahashi. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Takahashi, Chiaki
A Case of Progressive Stroke on Posterior Circulation with Transient Bilateral Oculomotor Palsy
title A Case of Progressive Stroke on Posterior Circulation with Transient Bilateral Oculomotor Palsy
title_full A Case of Progressive Stroke on Posterior Circulation with Transient Bilateral Oculomotor Palsy
title_fullStr A Case of Progressive Stroke on Posterior Circulation with Transient Bilateral Oculomotor Palsy
title_full_unstemmed A Case of Progressive Stroke on Posterior Circulation with Transient Bilateral Oculomotor Palsy
title_short A Case of Progressive Stroke on Posterior Circulation with Transient Bilateral Oculomotor Palsy
title_sort case of progressive stroke on posterior circulation with transient bilateral oculomotor palsy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5892245/
https://www.ncbi.nlm.nih.gov/pubmed/29785312
http://dx.doi.org/10.1155/2018/1579426
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