van der Graaff M M, Vanneste J A, Davies G A
Department of Neurology, St. Lucas Andreas Hospital, Amsterdam, The Netherlands.
J Neuroophthalmol. 2000 Jun;20(2):127-9. doi: 10.1097/00041327-200020020-00014.
Although vertical gaze palsy (VGP) is commonly associated with lesions of the rostral mesencephalon, there is some evidence that VGP may also be caused by a unilateral thalamic lesion. The case of a 68-year-old man with persistent upward gaze palsy after a unilateral thalamic infarction, demonstrated on computed tomography and magnetic resonance imaging scans, is presented. Subsequent high-resolution magnetic resonance scanning, however, showed involvement of the rostral mesencephalon as well. The authors suggest that in previous patients with VGP ascribed to a unilateral thalamic infarction, a coexisting mesencephalic involvement may have been missed because of inappropriate imaging techniques. Strong evidence of unilateral thalamic infarction as a cause of VGP is still lacking.
虽然垂直凝视麻痹（VGP）通常与中脑喙部病变相关，但有证据表明VGP也可能由单侧丘脑病变引起。本文报告了一名68岁男性病例，其在单侧丘脑梗死后出现持续向上凝视麻痹，计算机断层扫描和磁共振成像扫描显示了这一情况。然而，随后的高分辨率磁共振扫描显示中脑喙部也有受累。作者认为，在既往被归因于单侧丘脑梗死的VGP患者中，可能由于成像技术不当而漏诊了并存的中脑受累情况。目前仍缺乏单侧丘脑梗死作为VGP病因的有力证据。
