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Acute brainstem displacement without uncal herniation and posterior cerebral artery injury
  1. E F M Wijdicks
  1. Division of Critical Care Neurology, Mayo Clinic, Rochester, Minnesota, USA
  1. Dr E F M Wijdicks, Mayo Clinic College of Medicine, Division of Critical Care Neurology, 200 First Street SW, Rochester, MN 55905, USA; wijde{at}mayo.edu

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Posterior cerebral artery infarcts associated with brainstem shift have been traditionally associated with uncal herniation. We describe the first case of a peduncular infarct due to lateral brainstem displacement.

A 64-year-old man with a putaminal haemorrhage into the left putamen presented with eye opening to pain, localisation to pain, pupil anisocoria but intact pupil and corneal reflexes, gaze preference to the left and right hemiplegia. CT scan showed significant mass effect and early oedema. He …

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