Oculomotor nuclear complex infarction. Clinical and radiological correlation
J. Biller, R. Shapiro, L. S. Evans, J. R. Haag and M. Fine
We describe a patient with an isolated mesencephalic dorsal tegmental
infarct affecting the oculomotor nuclear complex and medial longitudinal
fasciculus, documented by high-resolution computed tomography, after
undergoing percutaneous transluminal coronary artery angioplasty.
Clinically, the patient exhibited bilateral ptosis, bilateral internuclear
ophthalmoplegia, transient convergence retractory nystagmus, and minimal
somnolence. We believe the combined clinical and radiological findings
favor the presence of a caudal, dorsal, and paramedian embolic infarct in
the territory of the paramedian branches of the mesencephalic artery as the
most likely mechanism for these exceptional findings and correlate them
with Warwick's scheme of the oculomotor subnuclei.
