Primary spontaneous mesencephalic hemorrhage

Excerpt

A 42 year old right-handed normotensive female patient was hospitalized because of syncope and sudden onset of headache. She had nausea and vomitus, but did not complain of dizziness, weakness, or numbness. On admission, her pulse was 103/min, and her blood pressure was 120/80 mmHg. She did not have any vascular risk factors or co-morbid diseases. Physical examination did not reveal any pathological signs. Neurological examination revealed no definite motor weakness, sensory impairment, or signs of meningeal irritation. Ophthalmologic examination was remarkable in that there was impaired upward gaze, more marked on the left side. Skew deviation was remarkable. …