Hamasaki S, Motomura M, Koga H, Nakamura T, Yoshimura T
First Department of Internal Medicine, Nagasaki University School of Medicine.
Rinsho Shinkeigaku. 1998 Apr;38(4):344-6.
A 76-year-old hypertensive man noticed sudden dizziness and diplopia. On examination, right-sided gaze deviation was present, but the remainder of the neurological examination was normal. Five days later, MRI revealed a small lesion in the left paramedian pontine tegmentum, which was consistent with pontine infarction. The conjugate deviation disappeared about two weeks after the onset, but a left lateral gaze and abducens nerve palsy have persisted at ten months after the infarct. MRI findings are unchanged. The site of infarction is presumed to be located in the caudal portion of paramedian reticular formation and the abducens nerve fascicle. Persistent lateral gaze palsy is rare in pontine infarction, and this case is important in illustrating the anatomical location of paramedian pontine reticular formation.
一名76岁的高血压男性突发头晕和复视。检查发现存在右侧凝视偏斜，但神经系统检查的其余部分正常。五天后，MRI显示脑桥被盖部左侧近中线处有一个小病灶，符合脑桥梗死。共轭偏斜在发病后约两周消失，但梗死十个月后左侧凝视和展神经麻痹仍持续存在。MRI表现无变化。梗死部位推测位于近中线网状结构的尾部和展神经束。持续性侧方凝视麻痹在脑桥梗死中罕见，该病例对于说明脑桥近中线网状结构的解剖位置具有重要意义。
