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Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis

We present the case of a 65-year-old patient who suffered a wake-up brainstem stroke. The only symptom reported by the patient was double vision. Upon examination, she was found to have left internuclear ophthalmoplegia and ipsilateral downbeat nystagmus. Magnetic resonance angiography revealed a un...

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Detalles Bibliográficos
Autor principal: Ivona, Javier A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7682511/
https://www.ncbi.nlm.nih.gov/pubmed/33240710
http://dx.doi.org/10.7759/cureus.11114
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author Ivona, Javier A
author_facet Ivona, Javier A
author_sort Ivona, Javier A
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description We present the case of a 65-year-old patient who suffered a wake-up brainstem stroke. The only symptom reported by the patient was double vision. Upon examination, she was found to have left internuclear ophthalmoplegia and ipsilateral downbeat nystagmus. Magnetic resonance angiography revealed a unilateral partial fetal posterior cerebral artery and unilateral posterior communicating artery hypoplasia. The patient was ineligible for intravenous thrombolysis: she evolved favorably with anti-platelet medication and was discharged after five days. We put forth a discussion on the clinical significance of these physical exams and magnetic resonance imaging findings.
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spelling pubmed-76825112020-11-24 Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis Ivona, Javier A Cureus Emergency Medicine We present the case of a 65-year-old patient who suffered a wake-up brainstem stroke. The only symptom reported by the patient was double vision. Upon examination, she was found to have left internuclear ophthalmoplegia and ipsilateral downbeat nystagmus. Magnetic resonance angiography revealed a unilateral partial fetal posterior cerebral artery and unilateral posterior communicating artery hypoplasia. The patient was ineligible for intravenous thrombolysis: she evolved favorably with anti-platelet medication and was discharged after five days. We put forth a discussion on the clinical significance of these physical exams and magnetic resonance imaging findings. Cureus 2020-10-23 /pmc/articles/PMC7682511/ /pubmed/33240710 http://dx.doi.org/10.7759/cureus.11114 Text en Copyright © 2020, Ivona et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Ivona, Javier A
Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis
title Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis
title_full Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis
title_fullStr Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis
title_full_unstemmed Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis
title_short Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis
title_sort brainstem stroke presenting as wake-up diplopia in a patient with an incomplete circle of willis
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7682511/
https://www.ncbi.nlm.nih.gov/pubmed/33240710
http://dx.doi.org/10.7759/cureus.11114
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