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Clinical Differences between Radiographic and Physical Horizontal Gaze Deviation: Utility of Using the Two in
1Department of Neurology, Asahi General Hospital, Asahi, Japan.
The Neurohospitalist
|June 19, 2024
Summary
Radiographic horizontal gaze deviation (RHGD) and physical horizontal gaze deviation (PHGD) are distinct findings in ischemic stroke. RHGD is more common and may indicate stroke side, aiding diagnosis when PHGD is absent.
Area of Science:
- Neurology
- Radiology
- Stroke Medicine
Background:
- Radiographic horizontal gaze deviation (RHGD) on CT scans is a potential indicator of supratentorial ischemic stroke laterality.
- The relationship between RHGD and physical horizontal gaze deviation (PHGD) remains unclear.
Purpose of the Study:
- To investigate whether RHGD is the same phenomenon as PHGD.
- To compare the frequency and characteristics of RHGD and PHGD in ischemic stroke patients.
Main Methods:
- Retrospective analysis of 671 ischemic stroke patients and 142 controls who underwent head CT.
- Comparison of clinical findings between RHGD-positive and RHGD-negative patients.
- Subgroup analysis based on stroke mechanisms and vascular territories, comparing RHGD and PHGD frequencies.
Main Results:
- Patients with RHGD were more likely to have PHGD.
- RHGD was more frequent than PHGD across all stroke subgroups, particularly in small-artery occlusion (SAO) and posterior inferior cerebellar artery (PICA) strokes.
- RHGD was often observed without PHGD, especially in PICA strokes (45.9%).
Conclusions:
- RHGD and PHGD exhibit different characteristics in ischemic stroke.
- Assessing both RHGD and PHGD may enhance diagnostic accuracy for stroke.
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