Keane J R
Arch Neurol. 1975 Feb;32(2):119-22. doi: 10.1001/archneur.1975.00490440069011.
Three patients with spontaneous supratentorial intracerebral hemorrhage had contralateral sustained conjugate gaze deviation. The autopsies disclosed large thalamic-basal ganglia hemorrhages whose caudal extension was limited to the midbrain. Current knowledge of oculomotor localization does not adequately explain this "wrong-side" gaze deviation, and the mechanism remains obscure. The present cases suggest that thalamic hemorrhage can produce contralateral gaze deviation without involving postdecussation horizontal oculomotor pathways. Contralateral gaze deviation is not a rare occurrence with deep supratentorial hemorrhages, and awareness of this confusing sign should assist in localizing intracerebral hematomas.
三名自发性幕上脑出血患者出现对侧持续性同向凝视偏斜。尸检发现丘脑 - 基底节区大量出血，其尾端延伸仅限于中脑。目前关于眼球运动定位的知识不足以解释这种“对侧”凝视偏斜，其机制仍不清楚。本病例提示丘脑出血可导致对侧凝视偏斜，而不涉及交叉后的水平眼球运动通路。对侧凝视偏斜在幕上深部脑出血中并不罕见，认识到这一易混淆的体征有助于脑内血肿的定位。
