Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 6, Number 12, December 2015, pages 572-575

Upward and Downward Gaze Palsy, Convergence Palsy, Concomitant Skew Deviation and Bilateral Light-Near Dissociation Due to a Unilateral Rostral and Dorsal Midbrain Infarction


Figure 1.
Figure 1. Pupil diameter was 5 mm in both eyes in an illuminated room. Palpebral aperture measured 8.5 mm in the both eyes (upper and left panel). Despite convergence palsy, near response of pupil was prompt in both eyes (upper and right panel). Upward and downward gaze palsy and concomitant skew deviation with left-sided hypotropia were observed. Upward gaze palsy was greater than downward (lower panels).
Figure 2.
Figure 2. Cranial magnetic resonance imaging on axial image (A-D: diffusion-weighted, D: magnification of B, E: apparent diffusion coefficient) demonstrated a localized infarct lesion in the rostral and dorsal midbrain on the left side (arrows).