Skew deviation as the initial manifestation of left paramedian thalamic infarction.
J Neuroophthalmol
; 28(4): 283-6, 2008 Dec.
Article
in En
| MEDLINE
| ID: mdl-19145125
ABSTRACT
We describe a 73-year-old man who developed diplopia as the initial manifestation of a left thalamic infarction. By the time he reached the emergency department, clouded consciousness precluded localization of the lesion. Results of brain MRI were initially interpreted as negative. Ophthalmologic examination several hours later disclosed a small vertical ocular misalignment attributed to skew deviation. This finding led to careful scrutiny of the upper brainstem on MRI. Comparison of the diffusion, apparent diffusion coefficient, and exponential apparent diffusion coefficient MRI studies allowed a diagnosis of subtle left thalamic infarction. The recognition of skew deviation in this setting is important because it may be the most specific indicator of a brainstem lesion.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Thalamic Diseases
/
Thalamus
/
Ocular Motility Disorders
/
Brain Infarction
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Screening_studies
Limits:
Aged
/
Humans
/
Male
Language:
En
Journal:
J Neuroophthalmol
Journal subject:
NEUROLOGIA
/
OFTALMOLOGIA
Year:
2008
Type:
Article
Affiliation country:
United States