Keane J R
Ann Neurol. 1981 Apr;9(4):409-12. doi: 10.1002/ana.410090418.
Coma with sustained upward gaze deviation followed cardiac arrest in 15 patients and prolonged systemic hypotension in 2 patients. Neuropathological examinations confirmed the expected diffuse cerebral and cerebellar damage with relative sparing of the brainstem. No focal lesions were found in the upper midbrain or pretectum. Six patients developed slow, downward-beating nystagmus as the forced upward gaze resolved. Four of 6 patients with posthypoxic facial myoclonic jerks demonstrated synchronous upward gaze movements. Forced upgaze in come usually is the result of severe hypoxic encephalopathy. While anatomical localization is obscure, this sign does not indicate a structural lesion in the pretectum or midbrain and may result from damage to cerebellar pathways.
15例患者在心脏骤停后出现昏迷伴持续性向上凝视偏斜，2例患者出现长时间系统性低血压。神经病理学检查证实存在预期的弥漫性脑和小脑损伤，脑干相对 spared。中脑上部或顶盖前区未发现局灶性病变。随着强迫性向上凝视缓解，6例患者出现缓慢的向下跳动性眼球震颤。6例缺氧后面部肌阵挛性抽搐患者中有4例表现出同步向上凝视运动。昏迷时的强迫性向上凝视通常是严重缺氧性脑病的结果。虽然解剖定位尚不明确，但该体征并不表明顶盖前区或中脑存在结构性病变，可能是小脑通路受损所致。 （注：“spared”此处根据语境意译为“ spared”较合适，原文可能有误，推测是“spared”，意为“ spared”）
