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...
Autor principal: | |
---|---|
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 |
_version_ | 1783313136445554688 |
---|---|
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. |
format | Online Article Text |
id | pubmed-5892245 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT takahashichiaki acaseofprogressivestrokeonposteriorcirculationwithtransientbilateraloculomotorpalsy AT takahashichiaki caseofprogressivestrokeonposteriorcirculationwithtransientbilateraloculomotorpalsy |