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Ptosis in patients with hemispheric strokes
L Averbuch-Heller1, R J Leigh, V Mermelstein
1Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Neurology
|February 28, 2002
Summary
Cerebral ptosis is a frequent complication of acute hemispheric stroke, affecting 37.5% of patients. This condition, particularly when bilateral, can signal an impending brain herniation.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurology
Background:
- Cerebral ptosis, often linked to right hemispheric lesions, is considered rare.
- Systematic studies on the frequency of ptosis in stroke patients are lacking.
Purpose of the Study:
- Determine the frequency of ptosis in acute hemispheric stroke patients.
- Identify stroke characteristics associated with ptosis.
Main Methods:
- Evaluated eyelid function in 64 acute hemispheric stroke patients and 40 controls.
- Conducted comprehensive neuro-ophthalmologic exams and CT scans.
- Included patients cooperative with eyelid testing.
Main Results:
- Neurogenic ptosis occurred in 37.5% of stroke patients (24/64), being bilateral in 10 and unilateral in 14.
- Ptosis was associated with hemiparesis, rightward gaze deviation, and upgaze paresis.
- Right hemispheric cortical infarction was more frequent in patients with ptosis.
- Complete bilateral ptosis preceded herniation signs in five patients.
Conclusions:
- Ptosis is a common finding in hemispheric stroke, particularly with right-sided lesions.
- Large infarctions frequently cause complete bilateral ptosis.
- Bilateral ptosis may indicate impending herniation.