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Midbrain Ischemic Strokes Presenting as Isolated Internuclear Opthalmoplegia
Dalys Haymes1, Matthew Jenson2, Chidi Nwachukwu2
1Neuroradiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.
Cureus
|October 18, 2021
Summary
Isolated internuclear ophthalmoparesis (INO) can indicate a midbrain ischemic stroke. This condition affects horizontal eye movements and is linked to specific midbrain vascular supply issues.
Area of Science:
- Neurology
- Neuro-ophthalmology
- Vascular Neurology
Background:
- Stroke diagnosis relies on identifying specific neurologic symptoms to localize the lesion.
- Internuclear ophthalmoparesis (INO) is a characteristic gaze abnormality affecting horizontal eye movements.
Observation:
- This study presents two cases of ischemic stroke localized to the midbrain presenting solely with INO.
- INO involves impaired adduction in one eye and abducting nystagmus in the contralateral eye.
Findings:
- INO can result from infarcts within the medial longitudinal fasciculus, located in the pons or midbrain.
- Midbrain ischemic strokes, particularly in the paramedian region supplied by specific arterial branches, can manifest as isolated INO.
Implications:
- Recognizing isolated INO as a potential sign of midbrain stroke is crucial for timely diagnosis and treatment.
- Understanding the intricate vascular anatomy of the midbrain aids in diagnosing stroke etiology and location.
