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Upward gaze palsy and convergence insufficiency as a rare presentation of primary intraventricular haemorrhage

Authors :
Masahiro Ebitani
Jun Tanimura
Takao Hashimoto
Hiromasa Sato
Source :
BMJ case reports. 14(10)
Publication Year :
2023

Abstract

A primary intraventricular haemorrhage (PIVH) usually presents with non-localised neurological symptoms since the haematoma is limited to the ventricles. However, it is sometimes associated with focal neurological signs, whose pathophysiologies are not confirmed. Here, we report on a case of PIVH who showed rare manifestations in the acute stage: upward gaze palsy and convergence insufficiency. The CT and MRI showed intraventricular haematoma without evidence of parenchymal haemorrhage, local mass effect around midbrain or hydrocephalus. There had been bilateral papilloedema, and it resolved along with improvement of the ophthalmic symptoms, suggesting a possible causal relation to increased intracranial pressure. The ophthalmic abnormalities suggested injury of the rostral part of the midbrain, especially the region around the dorsal midbrain tectum. It should be known that PIVH is one of the causes of acutely developing upward gaze palsy and convergence insufficiency.

Details

ISSN :
1757790X
Volume :
14
Issue :
10
Database :
OpenAIRE
Journal :
BMJ case reports
Accession number :
edsair.doi.dedup.....8760d2e47dd84f26818a42b831a93a41