Article Text

PDF
Unilateral midbrain infarct presenting as dorsal midbrain syndrome
  1. Meheroz H Rabadi
  1. Correspondence to Meheroz H Rabadi, Department of Neurology, Veterans Affairs Medical Center at Oklahoma University, 921 NE 13th Street, Oklahoma City, OK 73104, USA; rabadimh{at}gmail.com

Statistics from Altmetric.com

Introduction

Brainstem and cerebellar lesions are commonly associated with disorders of extraocular movements and these have localising value. The dorsal midbrain syndrome is characterised by (1) impaired voluntary vertical eye movements, (2) light-near dissociation of the pupillary response (pseudo-Argyll Robertson pupils), (3) convergence nystagmus on attempted upward gaze, (4) lid retraction (Collier sign) and (5) skew deviation.1 ,2 This syndrome is usually produced by pressure on the midbrain tectum.2 In this syndrome, the mesencephalic reticular formation that includes the rostral interstitial nucleus of medial longitudinal (riMLF) fasciculus and its connection with the interstitial N of Cajal and Darkschewitsch and the posterior commisure are involved. The riMLF is located dorsomedial to the rostral end of the red nucleus, rostral to the oculomotor nucleus and ventral to the periaqueductal grey matter (figure 1).3

Figure 1

Schematic diagram of the rostral midbrain.4 ,5 Monkey brainstem sagittal view demonstrating the locations of the ocular …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.