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"Wrong-way eyes" in supratentorial hemorrhage
Annals of Neurology
|January 1, 1981
Summary
A ruptured aneurysm caused a large frontal-perisylvian hemorrhage, leading to unusual "wrong-way" horizontal eye deviation. Autopsy confirmed the hemorrhage location but found no brainstem or thalamus lesion to explain this specific eye movement.
Area of Science:
- Neuroscience
- Neurology
- Ophthalmology
Background:
- Ruptured aneurysms can cause significant intracranial hemorrhage.
- Frontal lobe hemorrhages are associated with various neurological deficits.
- Conjugate horizontal eye deviation typically indicates specific brainstem or thalamic lesions.
Observation:
- A patient presented with conjugate horizontal eye deviation.
- The deviation was directed to the side opposite a large frontal-perisylvian hemorrhage.
- The hemorrhage resulted from a ruptured aneurysm.
Findings:
- Autopsy confirmed the hemorrhage was confined to the cerebral hemisphere.
- No lesions were identified in the brainstem or thalamus.
- This suggests a potential disconnect between hemispheric hemorrhage and the typical neuroanatomical correlates of eye deviation.
Implications:
- This case challenges the established understanding of the neuroanatomical pathways controlling horizontal eye deviation.
- It highlights the possibility of atypical neurological presentations following frontal lobe hemorrhages.
- Further research is needed to elucidate the mechanisms behind "wrong-way" eye deviation in such cases.