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Journal of Medical Case Reports

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Open Access 01-12-2012 | Case report

Midbrain hematoma presenting with isolated bilateral palsy of the third cranial nerve in a Moroccan man: a case report

Authors: Ouarda El Ouali, Ouafae Messouak, Mohamed Faouzi Belahsen

Published in: Journal of Medical Case Reports | Issue 1/2012

Abstract

Introduction

Bilateral third nerve palsy secondary to a hemorrhagic stroke is exceptional. To the best of our knowledge, no similar case has been reported in the literature.

Case presentation

We describe the case of a 69-year-old Moroccan man who presented with isolated sudden bilateral third nerve palsy. Computed tomography (CT) of the brain revealed a midbrain hematoma. The oculomotor function gradually and completely improved over eight months of follow-up.

Conclusion

Stroke should be included in the differential diagnosis of sudden isolated oculomotor paralysis even when it is bilateral because of the severity of the underlying disease and the importance of its therapeutic implications.

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Kim JS, Kang JK, Lee SA, Lee MC: Isolated or predominant ocular motor nerve palsy as a manifestation of brain stem stroke. Stroke. 1993, 24: 581-586. 10.1161/01.STR.24.4.581.CrossRefPubMed

Shintani S, Tsuruoka S, Minato Y, Shiigai T: Radiologic-clinical correlation, isolated third nerve palsy caused by midbrain hemorrhage. Am J Neuroradiol. 1994, 15: 1508-1511.PubMed

Tachibana H, Mimura O, Shiomi M, Oono T: Bilateral trochlear nerve palsies from a brainstem hematoma. Clin Neuroophtalmol. 1990, 10: 35-37.

López-Serna R, González-Carmona P, López-Martínez M: Bilateral thalamic stroke due to occlusion of the artery of Percheron in a patient with patent foramen ovale: a case report. JMedCase Rep. 2009, 3: 7392.

Walsh and Hoyt’s Clinical Neuro-Ophtalmology. The Autonomic Nervous System: disorders of pupillary function, accommodation and lacrimation. Volume 1. Edited by: Miller NR, Newman NJ. 2005, Lippincott Williams and Wilkins, , 739-804. Sixth edition

Michael J, Link JD, Bartleson D, Glenn F, Frederic B, Meyer B: Spontaneous midbrain hemorrhage: report of seven new cases. Surg Neurol. 1993, 39: 58-65. 10.1016/0090-3019(93)90112-E.CrossRef

Tomecek FJ, Morgan JK: Ophtalmoplegia with bilateral ptosis secondary to midbrain hemorrhage. A case with clinical and radiologic correlation. Surg Neurol. 1994, 41: 131-136. 10.1016/0090-3019(94)90110-4.CrossRefPubMed

Thiam A, Ndiaye M: Hématome pédonculaire bénin: A propos de deux cas révélés par la tomodensitométrie. Méd Afr Noire. 2000, 47: 520-524.

Abrar A, Anil D: Isolated third nerve palsy due to mesencephalic hematoma. Indian J Neurotrauma. 2007, 4: 53-54.CrossRef

10.

Shuaib A, Murphy W: Mesencephalic hemorrhage and third nerve palsy. J Computed Tomography. 1987, 11: 385-389. 10.1016/0149-936X(87)90078-6.CrossRef

Title: Midbrain hematoma presenting with isolated bilateral palsy of the third cranial nerve in a Moroccan man: a case report
Authors: Ouarda El Ouali
Ouafae Messouak
Mohamed Faouzi Belahsen
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2012
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/1752-1947-6-197

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Midbrain hematoma presenting with isolated bilateral palsy of the third cranial nerve in a Moroccan man: a case report

Abstract

Introduction

Case presentation

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case presentation

Conclusion

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