[Retrocollis and oculogyric crisis in association with bilateral putaminal hemorrhages]

A 50-year-old man with a history of hypertension developed right hemiparesis in February, 1985. Four years later, he noted tremor and involuntary extension of the neck (retrocollis) which was aggravated by walking or emotional stimuli. In addition to retrocollis, which was most pronounced upon turning the head to the left or backward, there also was upward deviation of the eyes (oculogyric crisis) and contraction of the left orbicularis oculi muscle. Magnetic resonance imaging study revealed one small old hematoma in the left posterior putamen and two in the right lenticular nucleus (one in the posterior putamen and the other in the globus pallidus). The findings in this case and in other reported cases of symptomatic retrocollis suggest that bilateral lesions of the putamen are associated with this type of focal dystonia.