tailieunhanh - báo cáo khoa học: "A rare midbrain infarction presenting with plusminus lid syndrome with ataxia: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:A rare midbrain infarction presenting with plusminus lid syndrome with ataxia: a case report | Alsherbini et al. Journal of Medical Case Reports 2011 5 525 http content 5 1 525 WV journalof medical l rCASE REPORTS CASE REPORT Open Access A rare midbrain infarction presenting with plusminus lid syndrome with ataxia a case report Khalid Alsherbini Kevin Kapadia and Justin A Sattin Abstract Introduction We present the case of a patient with midbrain infarction with an unusual clinical presentation where clinical diagnosis and anatomical localization were valuable tools in deciding treatment. Case presentation Our patient was a 59-year-old right-handed Caucasian man with hypertension who presented to our facility with acute diplopia that persisted until he developed complete right-sided ptosis. He also had difficulty walking and coordinating movements of his upper extremities bilaterally but this was worse on his left side. Conclusions Plus-minus lid syndrome with ataxia is a rare presentation of midbrain infarction with a unique localization and anatomical description. This case highlights the importance of clinical skills for making a diagnosis in the absence of imaging to confirm the findings. Introduction A total of 20 of ischemic strokes involve structures supplied by the posterior vertebrobasilar circulation. Many cases remain undiagnosed or incorrectly diagnosed because of the atypical clinical presentation and the lower sensitivity of diagnostic imaging of the posterior fossa. Although lacunar infarctions are usually less than 15 mm in diameter the symptoms might be clinically devastating especially when the midbrain or pons is affected. Such lesions often are very challenging to localize and require a thorough knowledge of neuroanatomy. Case presentation Our patient was a 59-year-old right-handed Caucasian man with hypertension who presented to our facility with acute diplopia that persisted until he developed complete right-sided ptosis. He also had difficulty walking and coordinating movements of his upper extremities .