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Three Pathologically Verified Cases

James R. Keane, MD

Arch Neurol. 1975;32(2):119-122.

Abstract
Three patients with spontaneous supratentorial intracerebral hemorrhage had contralateral sustained conjugate gaze deviation. The autopsies disclosed large thalamic-basal ganglia hemorrhages whose caudal extension was limited to the midbrain. Current knowledge of oculomotor localization does not adequately explain this "wrong-side" gaze deviation, and the mechanism remains obscure. The present cases suggest that thalamic hemorrhage can produce contralateral gaze deviation without involving postdecussation horizontal oculomotor pathways. Contralateral gaze deviation is not a rare occurrence with deep supratentorial hemorrhages, and awareness of this confusing sign should assist in localizing intracerebral hematomas.

Author Affiliations
From the Department of Neurology, Los Angeles County-University of Southern California Medical Center, Los Angeles.

Footnotes
Accepted for publication May 13, 1974.

Reprint requests to Box 359, 1200 N State St, Los Angeles, CA 90033 (Dr. Keane).

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