Işikay C T, Yücesan C, Yücemen N, Culcuoglu A, Mutluer N
Ankara University Faculty of Medicine, Department of Neurology, Ankara, Turkey.
Acta Neurol Belg. 2000 Dec;100(4):248-51.
Unilateral third nerve palsy with bilateral superior rectus paresis and bilateral ptosis is a typical condition for nuclear oculomotor nerve syndrome. We report a case of nuclear oculomotor nerve syndrome due to midbrain hemorrhage, as a rare cause. A 73-year-old man presented with an abrupt onset of double vision and difficulty opening his eyes. He had uncontrolled hypertension in his history. Neurological examination revealed right oculomotor palsy with impairment of bilateral upward gaze and bilateral ptosis. MRI showed a mesencephalic area of increased T1 signal and decreased T2 signal consistent with a subacute hematoma. It is emphasized that isolated mesencephalic hemorrhage may be the cause of the nuclear oculomotor nerve syndrome without associated neurological signs.
单侧动眼神经麻痹伴双侧上直肌麻痹和双侧上睑下垂是核性动眼神经综合征的典型表现。我们报告一例因中脑出血导致的核性动眼神经综合征病例，这是一种罕见病因。一名73岁男性突然出现复视和睁眼困难。他有高血压病史且血压控制不佳。神经系统检查发现右眼动眼神经麻痹，伴有双侧向上凝视障碍和双侧上睑下垂。MRI显示中脑区域T1信号增强、T2信号减弱，符合亚急性血肿表现。需要强调的是，孤立性中脑出血可能是核性动眼神经综合征的病因，且无相关神经系统体征。
